Instructions: fill out form, choose ‘print’ icon then ‘save as pdf’ and email form from your device to financialaid@rpcc.edu
Financial Aid Appeal Form
Summer Priority Deadline May 21, 2020 / Summer Final Deadline June 18, 2020
Fall Priority Deadline August 6, 2020 / Fall Final Deadline September 18, 2020
Spring Priority Deadline January 4, 2021 / Spring Final Deadline February 12, 2021
Student Name: _________________________________________ Student ID#: _________________________________________
Student Mailing Address: __________________________________ Telephone Number__________________________________
Email Address: _______________________________________________________________________________________________
Semester you are requesting an appeal: Year ___________________________________
Fall ___________ Spring _____________ Summer ____________
ATTENTION STUDENTS: Submitting this form does not guarantee reinstatement of financial aid or academic standing. The student is responsible
for any charges incurred during periods of ineligibility even if the appeal is not approved. You will be notified of the outcome of your appeal by
email once a decision has been made.
INSTRUCTIONS: Complete steps 1-4 below, and submit this completed form with all supporting documentation to the Office of Financial Aid.
Submission of the appeal without documentation WILL BE DENIED.
Unacceptable reasons to submit an appeal:
lack of knowledge that your financial aid was in jeopardy
lack of knowledge relating to your major, courses scheduled and class attendance policy
lack of transportation
lack of focus or commitment to your education
________________________________________________________________________________________________________________________
For Office Use Only
Previous Appeals: ___Yes ____ No Reason for Appeal □ GPA □ Pace of Progression □ Maximum Timeframe
Approval Conditions:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Denial Reasons:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Committee: ___ Approved: ___ Denied: Signature: ___________________________________________________ Date: __ /_ _ /__
___ Approved: ___ Denied: Signature: ____________________________________________________________ Date: _ _/_ _/_ _
___ Approved: ___ Denied: Signature: ____________________________________________________________ Date: _ _/_ _/_ _
___ Approved: ___ Denied: Signature: ____________________________________________________________ Date: _ _/_ _/_ _
Office of Financial Aid & Scholarships
Gonzales-Westside-Reserve Campuses
Financialaid@rpcc.edu
STEP 1: Please Indicate Type of Appeal: (select all that apply)
GPA/PACE Must maintain a 2.00 GPA and complete at least 67% of the classes attempted
Max Hours (Must explain why you have exceeded the maximum amount of credit hours to be eligible for financial aid. Examples:
changed major, second degree, etc.)
Change in major (Provide change of major form)
Double major (Attach official documentation of approval)
EXTENUATING CIRCUMSTANCES: Extenuating circumstances are considered significant, life altering circumstances that have made an
impact to your emotional and/or physical health thus causing the prevention of positive academic progress while meeting SAP.
Please select one of the extenuating circumstances:
Medical illness and/or injury (supported by medical documentation)
Death in immediate family: parent, spouse, child, grandparents, siblings, aunts or uncles (supported by copy of death certificate
AND/OR obituary)
Call to active military duty (supported by copy of military orders)
Legal problems or police matters including Incarceration (supported by legal documentation)
Foreclosure or eviction (supported by documentation)
Out of college for a minimum of 3 years
All of the examples above must pertain to the semester(s) in which you did not meet Satisfactory Academic Progress.
STEP 2: APPEAL STATEMENT: Attach a typed statement describing the circumstance that kept you from meeting the established academic
standards during your previous semester(s).
STEP 3: PERFORMANCE PLAN: Attach a typed statement describing how you plan to keep this situation from affecting your academic progress in
future semesters.
STEP 4: ACADEMIC PLAN (Financial Aid Only): The requirements within the Academic Plan must be met to regain eligibility. Students will need to
meet the standards of the Academic Plan each semester until meeting the SAP standards.
Not enrolling in college for a period of time then re-enrolling will not bring the student into compliance with the SAP policy, and may require the
student’s academic plan to be re-adjusted.
At minimum, the Academic Plan will require that the student do the following:
1.) Earn a minimum GPA of 2.25 each semester
2.) Pass at least 75% of all hours attempted each semester
Please read and confirm by initialing next to each statement:
_____ I must make at least a 2.25 semester GPA in the courses that I am taking each semester until meeting the SAP standards.
______ I must pass at least 75% of all hours attempted each semester with a “C” or better until meeting the SAP standards.
(Final Grades of D, F, W or I will not be accepted).
STEP 5: CERTIFICATION: I certify all of the information submitted is accurate. I further understand that an incomplete appeal, including missing or
insufficient documentation, will be denied. I fully understand that an approved appeal will have conditions stated in the approval and those
conditions must be met in order to be considered for any future aid.
Student Signature: _____________________________________________________________________ Date: _________________________
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