Fill - Free fillable Based on the submission of your recent FAFSA, (Southwestern Michigan College) PDF form

Unusual Enrollment Appeal Form 3.13.14

Based on the submission of your recent FAFSA, the United States Department of Education determined that you have an

unusual enrollment history while receiving federal Pell Grant funds. An unusual enrollment history is defined by the

Department of Education as having received the Pell Grant at multiple institutions over the past three award years. Upon

review of your academic records it has been determined that you did not earn academic credit at one or more of your

previously attended institutions. Under federal guidelines our office is unable to award you any Title IV funds until an appeal

is received that satisfactorily explains the reason(s) you failed to earn academic credit.

If you wish to appeal, please complete this form providing an explanation of the extenuating circumstance(s) during the

semester(s) in which you did not receive academic credit. Examples of extenuating circumstances include serious medical

problems, natural disasters, a death in the family, etc. Students should provide supporting documentation (medical reports,

news articles, police or fire dept. reports, etc.) with their letter of explanation.

Appeals are reviewed by the Financial Aid Director. Normally a decision is reached and students are mailed a letter informing

them of the Director’s decision within 14 days.

A. STUDENT INFORMATION

Student Name:___________________________ ID Number: N__________________________

B. EXPLANATION

Name of School: Semester:

________________________________________________________________________________________

C. CERTIFICATION

I certify that all of the information I have provided on this Appeal Form and all supporting documentation is

true and accurate to the best of my knowledge. I understand that it is a federal crime to purposely give false

or misleading information on this form and if I do, I may be fined, be sentenced to jail, or both.

Student Signature:_____________________________________ Date:________________________

Return this form to:

Financial Aid Office, Southwestern Michigan College

58900 Cherry Grove Road, Dowagiac, MI 49047 or fax to 269-783-2114

Fill Online, Printable, Fillable, Blank Based on the submission of your recent FAFSA, (Southwestern Michigan College) Form