Office of Financial Aid
Exemption/Waiver Appeal
Name: (Last, First)
Student ID:
Phone:
E-Mail Address:
Mailing Address:
What factors contributed to you not being able to make Satisfactory Academic Progress?
Check the reason for filing this appeal:
_____ Due to a severe illness or debilitating condition.
_____ I was responsible for the care of a sick family member
_____ I was on active duty or other service in US Armed Forces or Texas National Guard
_____ Due to a different case not listed above.
********** Documentation must be provided with this appeal that meets the reason you checked above ********
Explain how the situation marked above affected your Academic Progress and/or GPA
I certify that the information and supporting documentation provided with this form is true and correct and that
I have not enrolled at NCTC for the sole purpose of receiving Title IV credit balance refunds. I also understand
that it may take up to 30 days to receive a decision concerning this appeal.
Signature: (electronic signatures are NOT accepted)
Date:
FINANCIAL AID OFFICE USE ONLY
Date Approved:
Date Denied:
Date Received:
Term Approved:
COMMENTS
AWARDED
DATE LETTER SENT:
OFA OFFICER: