Financial Aid Adjustment/Cancellation Form
Allegheny Campus Boyce Campus North Campus South Campus
808 Ridge Avenue 595 Beatty Road 8701 Perry Highway 1750 Clairton Road
Pittsburgh, PA 15212 Monroeville, PA 15146 Pittsburgh, PA 15237 West Mifflin, PA 15122
Ph: 412.237.2589 Ph: 724.325.6602 Ph: 412.369.3656 Ph: 412.469.6241
FAX: 412.237.3171 FAX: 412.237.3173 FAX: 412.237.3175 FAX: 412.237.3177
Student Name: Student ID:
I am requesting that CCAC:
Cancel all aid (grants and loans)
to $ Reduce my Federal Direct Loan from $_________ __________
to $_ Increase my Federal Direct Loan from $________ _________
Reduce my Alternative Loan from $_________to $___________
For the following semesters:
Fall 20
Spring 20
Summer 20
Reason for Cancellation:
Transferring to
School Name
By signing below, I understand and agree that:
I must withdraw from classes with the registrar’s office. Cancelling my financial aid does not withdraw me
from classes.
I am responsible for any balance owed to CCAC resulting from my decision to cancel my financial aid.
If I am not transferring to another school, my student loans will enter their six month grace period and
possible repayment. It is my responsibility to contact my lender(s) of any changes.
Student Signature Date
Notifications of nondiscrimination and contact information can be found at, search keywords “notifications of nondiscrimination.”
Revised: February 23, 2018
click to sign
click to edit
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