PLCHG
PLUS
LOAN CHANGE REQUEST FORM
(2019-2020 Academic Year)
2800 S Lone Tree Rd Flagstaff, AZ 86005-2701 PH: 928-226-4219 FAX: 928-226-4110 finaid@coconino.edu
FA-210-PLCHG 20181003
CANCEL: To CANCEL your loan check () the appropriate boxes:
Please CANCEL my PLUS Loan for:
Fall 2019
Spring 2020
Summer 2020
REDUCE: To REDUCE your loan, check () the appropriate boxes and enter the new TOTAL amount you want your
loans to be:
Please REDUCE my PLUS
Loan to:
$ _____ for Fall 2019 $ _____ for Spring 2020 $ _____ for Summer 2020
INCREASE: To INCREASE your loan, check () the appropriate boxes and enter the new TOTAL amount you want
your loans to be:
Please INCREASE my
PLUS Loan to:
$ _____ for Fall 2019 $ _____ for Spring 2020 $ _____ for Summer 2020
CHANGE WHEN I GET THE LOAN:
To CHANGE the loan period of one or more of your existing loans, check () the appropriate boxes below:
*Federal regulations require all loans be issued in two disbursements; if you are requesting a one semester loan the 1
st
half of your loan
will be issued with the first disbursement of the semester and the 2
nd
disbursement will occur at the mid-point of the semester.
P
lease CHANGE my PLUS Loan period to:
Fall 2019 and Spring 2020
Fall 2019 Only *
Spring 2020 Only *
OS
FA Use Only:
Processed by: Date:
CCC ID# Student’s Last Name Student’s First Name MI
Students Mailing Address City ST Zip Code
Telephone No. (include area code) Email Address
