Section I to be completed by student (PLEASE NEATLY PRINT all information as requested)
Student’s name Email
Program City & Program Name
Fill in Year 20 Check the term that applies: Fall
Spring Summer_
Students are responsible for forwarding payment to CIEE for any remaining balance due between the total amount
of anticipated aid (after home school fees are deducted) and the total fees billed to the student. Participant
payments for balances above what is covered by financial aid must be received by CIEE no later than the original
due date as noted on the bill sent to the student.
Financial Aid payments must all be received by CIEE (either from the school or from the student), no later than:
October 15 for fall term balances
January 10 for short-term January program balances
March 15 for spring term balances
July 1 for summer program balances
Students are responsible for reporting any changes to their financial aid award amounts or aid disbursement schedule to
CIEE if the change impacts the established deferral plan. CIEE will not bill universities solely to facilitate financial aid
processingit is the students responsibility to forward a copy of his/her bill to the home school if this is required in order for
the aid to be released.
I understand that I am ultimately responsible for ensuring that my CIEE program fees are paid in full (not my home school
financial aid office). I understand that if financial aid payments are not made per the above timeline, I am fully liable for any
applicable late fees as explained in the CIEE Payment Policies ( Exceptions to these policies/timelines may
only be granted by the CIEE Billing Coordinator. I also understand that I am fully liable for all outstanding program fees as
determined by CIEE’s Withdrawal or Deferral Refund policy, should I withdraw from the program before it begins or leave
once it has begun. I authorize my Financial Aid Officer to release the disbursement information requested below to CIEE.
Date St
udent’s Signature
Section II to be completed by Financial Aid Administrator: Financial Aid Disbursement Schedule
I certify that estimated financial aid/scholarships for the above named student will be disbursed according to the following
anticipated schedule (please add attachments for documentation or explanation of potential change to award if needed).
Please only list awards/disbursements for one semester per form with the financial aid that will be available
for payment for the CIEE student bill.
Type of Aid
Date Aid Will Be
Disbursed from
This section must be completed
Anticipated balance of financial aid (AFTER home school and/or loan
origination fees are deducted):
Total amount from above to be sent to: Student $ CIEE $
Financial Aid Advisor Printed Name Financial Aid Advisor Signature
Email Address Daytime Telephone Number
Please return the completed form by email to
Financial Aid Deferral Request Form
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