Fillable FINANCIAL HARDSHIP Appeal for Reduction of Full Cost (Miami Dade College)

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FINANCIAL HARDSHIP Appeal for Reduction of Full Cost (Miami Dade College)

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Appeal for Reduction of Full Cost of Instruction Fees for College Credit Course(s) Based on
FINANCIAL HARDSHIP
Florida Statute 1009.285 places responsibility for the full cost of College Credit Instruction on the student after the second
attempt. The legislation also provides a one-time exception to the increased fees due to financial hardship. Financial hardships
are restricted to those instances where the student qualifies for need-based Financial Aid (Federal, State or MDC).
Read and follow the instructions on the back of this form to determine your eligibility for a fee reduction. You must
be receiving at least one of the Financial Aid need-based programs listed below to be eligible to file this Petition.
STUDENT INFORMATION (PRINT)
Last name: First name: Middle initial:
MDID: Email:
COURSE(S) INFORMATION (PRINT)
Course Abbr. Class Number Term Course Abbr. Class Number Term
Course Abbr. Class Number Term Course Abbr. Class Number Term
Course Abbr. Class Number Term Course Abbr. Class Number Term
Student Signature Date:
I understand that if my appeal is approved, this is the only appeal for the course(s) that I can receive.
Please initial and date here that you have read the statement above. (Your initials):__________Date: _________
APPEAL MUST BE SUBMITTED BY THE 100% REFUND DATE
Return your appeal form to the following office at your Campus:
Campus Department Location / Contact
North Advisement & Career Services Building 1 – Room 1104-13 – (305) 237-1425
Kendall Retention and Transition Office Building R – Room R118 – (305) 237-0529
Wolfson Dean of Students Office Room 3108 – (305) – (305) 237-3007
Medical Admissions & Records Building 1 – Room 1201 – (305) 237-4444
Homestead Advisement & Career Services Building A – Room A233 – (305) 237-5046
InterAmerican New Student Services Building 1 – Room 1121 – (305) 237-6271
Hialeah Dean of Students Office Building 1 – Room 2101-11 – (305) 237-8715
West Student and Administrative Services Building 2 – Room 2109 – (305) 237-4917
Meek Entrepreneurial
Education Center
Student Services Room 1101 – (305) 237-1900
FOR MDC OFFICE USE ONLY
Approved ______ MDC Employee Name & Signature Date
Denied ______ MDC Employee Name & Signature Date
INSTRUCTIONS FOR THE STUDENT
1. READ the following guidelines and follow these steps to to determine your eligibility before completing the Appeal Form.
You must be receiving at least one of the Financial Aid need-based programs listed below to be eligible to file this Appeal.
2. ✔ each of the Financial Aid categories that are currently providing aid to you.
Federal Programs State Programs MDC Programs
_____ College Work Study _____ Florida Work Experience Program _____ Need Scholarship
_____ America Reads Program _____ Rosewood Scholarship _____ Middle Income Grant
_____ Community Services _____ Florida Student Asst. Grant _____ HS Achievement
_____ Pell Grant _____ Jose Marti Scholarship Need-Based Scholarship
_____ Supplemental Educational _____ Other (name here)
Opportunity Grant ________________________
_____ Nursing Scholarship
_____ Stafford Loan
_____ Perkins Loan
3. COMPLETE this Appeal Form.
4. TYPE AND SIGN a personal statement describing the situation and the reason(s) why you are requesting a fee reduction.
Be specific: indicate dates/time periods, names of individuals you spoke with and their department(s), and how your
financial circumstances prohibited you from fulfilling the academic requirements of the course during your first two
attempts. You must include this in your Appeal package.
5. ATTACH at least one of the following required and relevant supporting documents with your Petition to provide written
proof to support your claim of financial hardship for this Petition.
a. Bank statements
b. Bankruptcy documents
c. Eviction notice
d. Foreclosure documents
e. Notice of termination from work
f. Unemployment benefits’ documents
6. ATTACH all of the following:
a. a copy of your Student Aid Report indicating your EFC / FAFSA / Financial Aid Award letter for the term you
are registered to take the course; it must reflect an award amount. You can access and print your awards letter
online at http://www.mdc.edu/main/financialaid/.
Click on “My Awards”, AND
b. an approved copy of your SMART Action Plan detailing your strategy for passing the course this time, AND
c. a current Academic Requirements Report (Degree Audit) or unofficial transcript, AND
d. a copy of your course schedule, reflecting registration for the course at an MDC Campus for the current term.
7. COPY your Appeal Form and documentation to keep for your records.
8. SUBMIT your original, completed Appeal packet to the Dean of Students’ Office by the 100% Refund date.
REV. 3/18
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FINANCIAL HARDSHIP Appeal for Reduction of Full Cost (Miami Dade College)

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Completed 7 November 2020

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