2020-21 UNUSUAL ENROLLMENT
HISTORY PETITION FORM
STUDENT INFORMATION
LAST FIRST MI BRANDMAN ID NUMBER
According to the federal government, you have attended three or more institutions during the last four
years where you received Federal Student Aid funds. Federal financial aid eligibility rules require that
students earn academic credit at each of the schools where they received aid during this period. A
review of your transcripts indicates this federal requirement was not met at one or more of the
institutions you attended. As a result, you are no longer eligible for assistance.
If there was an extraordinary situation that prevented you from passing your classes, you may petition
for reinstatement of assistance by completing this form and providing third party documentation.
Please indicate the relevant circumstance below and attach to this form the necessary documentation
related to your situation for each instance where no credit was earned.
Death of an immediate family member (include the relationship of family member to you and a
copy of the death certificate, funeral program, or obituary)
Documented illness or injury suffered by you (include dates and documentation of illness or
injury and statement from a physician that you are sufficiently recovered to return to school)
Documented illness or injury of a family member that required your care (include the nature of
the care you provided, the dates and documentation of the illness or injury, and a statement
explaining why your care is no longer needed)
Military withdrawal from classes due to change of duty assignment (include copy of orders,
statement from commanding officer, or other suitable document)
Victim of a crime or unexpected disaster (include copy of police report, third party letters, etc.)
Other circumstances not addressed in the above categories (include third party documentation)
In addition to the relevant third party documentation described above, also attach to this form:
1. Detailed letter of explanation that addresses the circumstances that prevented you from earning
academic credit at one or more of the schools where you received Federal Student Aid during
the past four academic years. Please refer to the name of the school and academic period in
question on all letters and documentation. Explain only situations that occurred during the
academic terms in which you received aid but did not obtain academic credit.
2. Provide a separate statement detailing what will be different about your academic career at
Brandman University and the strategies you will take to complete your courses successfully.
CERTIFICATION STATEMENT: I certify that all of the information related to this petition is complete
and correct.
STUDENT SIGNATURE DATE
Submit via the student portal OR Fax completed form to: 866-659-1147
Or mail to: Brandman University, Financial Aid Office, Third Floor, 16355 Laguna Canyon Rd, Irvine, CA 92618
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