Cost of Attendance Appeal Form
Student Information
B Number
Name
Email Address
Phone Number
Academic Year: 20_____--- 20_____
The Cost of Attendance (COA) consists of direct and indirect costs related to your education expenses,
including tuition, mandatory fees, room and board, books and supplies, and transportation. If you have
recently incurred expenses above your COA, you may file an appeal. For your current COA, please refer
to your financial aid award letter located in your mybarstow student portal.
Please complete this form and submit along with a personal statement requesting a review of your
standard cost of attendance. Please provide supporting documentation as requested.
Your appeal will not be reviewed until all required documents are received.
COA Appeals are evaluated on a case-by-case basis and does not guarantee approval.
With this form, I am requesting a Cost of Attendance Appeal for (please indicate year):
FALL __________ SPRING __________ SUMMER __________
Source
Monthly Expense
Source
Monthly Expense
Rent/Mortgage
Gas (Heating)
Electric
Health Insurance
Water/Trash/Sewer
Auto Insurance
Phone/Cable/Internet
Computer Expenses (one
time)
Car Payment
Homeowner’s Insurance
Gas (Vehicle)
Property Taxes
Child Care
Other
* Provide a current rental/lease agreement or a current mortgage statement.
* For all utilities, provide 6 months worth of billing statements for each.
* Childcare expenses must be incurred solely due to full time enrollment in school. Provide tuition contract and/or
receipt.
* Students are allowed to include a one-time computer purchase for his/her program. Provide receipt of purchase.
* Please provide monthly or quarterly receipts for each other expense listed above.
* Please define “OTHER” in your personal statement and provide supporting documentation.
Before submitting this appeal to the Office of Financial Aid, please be sure that you have enclosed the
following:
1. Personal Statement
2. This form Signed & Completed
3. All Supporting Documentation
Completed Cost of Attendance Appeals packets should be submitted to the Financial Aid Office via email
at finaid@barstow.edu
.
The appeal may be granted at the discretion of the Office of Financial Aid. If supporting documentation
is not sufficient, additional documents may be requested. If the Office of Financial Aid determines that
the monthly expense appears unusually high or inconsistent with other average area expenses, the
Office may approve a reduced allowance of the expense.
By signing, I (we) certify that all information reported on this worksheet is complete and correct. At
least one parent (if student is dependent) must also sign. Warning: If you purposely give false or
misleading information on this worksheet, you may be fined, sentenced to jail, or both.
______________________________________________________________________________
Student Signature Date
______________________________________________________________________________
Signature of Parent (if applicable) Date
Questions should be directed to the Financial Aid Office:
Email: finaid@barstow.edu
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