NOTE: This form is required ONLY if you wish to make a change to the financial aid listed in your financial award
letter. Unless we receive a “Change Form” we will assume you wish to keep the full amount of all loans as
offered in your financial aid award letter.
_________________________________ ____________________ 20 _ _ - 20_ _
Student’s Name (please print) I.D. # Academic Year
Randolph-Macon Financial Aid you wish to change:
LOAN you want to CHANGE Enter Loan Amount you want to KEEP or
Enter “O” if you want to CANCEL entire Loan
Loan amounts are divided 50/50 for Fall/Spring
Outside Source Scholarship/Grants to be added to your R-MC Financial Aid Package:
Please report any Private Scholarships that you have been awarded that are not currently listed on your
Financial Aid Award Letter. (Do not include Randolph-Macon Scholarships/Awards)
REQUIRED: Please attach a copy of the scholarship award letter. Scholarship funds are disbursed
according to the donor specifications outline in the scholarship award letter.
Name of Private Scholarship Scholarship Amount
I certify that the information provided on this form is complete and correct to the best of my knowledge.
_________________________________________ ___________________
Student’s Signature Date
Randolph-Macon College - Office of Financial Aid - P. O. Box 5005 - Ashland, VA 23005
Telephone (804) 752-7259 - Fax (804) 752-3719 -