ADS 79 1/15
Petition for Tuition Refund
Auburn Hills Campus Highland Lakes Campus Orchard Ridge Campus Royal Oak Campus Southeld Campus
2900 Featherstone Rd. 7350 Cooley Lake Rd. 27055 Orchard Lake Rd. 739 S. Washington 22322 Rutland Dr.
Auburn Hills, MI 48326-2845 Waterford, MI 48327-4187 Farmington Hills, MI 48334-4579 Royal Oak, MI 48067-3898 Southeld, MI 48075-4793
Street City ZIP
Telephone ( ) Telephone ( )
Day Evening Call Day Evening Call
• You must ofcially drop from all sections that you are appealing.
• Financial Aid Recipients: Dropping courses could affect both your current nancial aid award and your eligibility for future nancial assistance.
It is recommended that you contact the Financial Aid Ofce before dropping to understand the consequences of this action.
• If you have a medical or work-related reason for dropping, please contact the Enrollment Services Department for college guidelines before
submitting this form.
I understand that dissatisfaction with a particular teaching style, lack of knowledge of refund deadlines, and disagreement with refund policies
are not grounds for refunds. I understand that I must drop from the course(s) in question before a refund can be considered. I also understand
that submission of this form does not guarantee a refund. I understand that registration and technology fees are non-refundable.
COURSE CODES SECTION NUMBERS SEMESTER YEAR
Course Section Fall
Course Section Winter
Course Section Summer I
Course Section Summer II
Please give a detailed explanation of your request (which should be chronological and give specic dates) on the reverse side, and attach any
documentation that may support your claim.
REFUND TYPE: 50% Refund Invoice Cancellation Removal of no show grade
Hand deliver or mail to the Enrollment Services Department at any of the campuses listed above.
Student Signature Date
Note: You will receive a written notication of approval or denial. If approved, refund checks will be mailed within 4-6 weeks of the notication date.
DO NOT WRITE IN THIS SPACE - FOR OFFICE USE ONLY
Request approved. Process for: 50% of tuition and course fees only Invoice Cancellation Other
Denied Additional Information Required Notication Sent
Dean of Campus Affairs Signature Date