Financial Aid Deferment Form
Bring the completed form to the KRC Bookstore/KBC Registration Clerk for deferment of tuition, fees, and *books.
Semester (Circle one): Fall Spring Summer 20__ __ _____________________ __
Student ID #
Name: ______________________________________________________________________________
Driver’s License#: _________________________ Date of Birth: ______________________________
Mailing address: ______________________________________________________________________
Permanent Address: ___________________________________________________________________
Phone#:__________________________________ Email: ___________________________________
Most Recent Employer: ___________________________ Phone #
PERSONAL REFERENCES
Reference: _____________________________ Reference: ________________________________
Address: ______________________________ Address: _________________________________
City/State: _____________________________ City/State: ________________________________
Phone#: _______________________________ Phone#: __________________________________
NOTICE FOR STUDENTS IN UAA, UAS, & UAF DISTANCE COURSES: THESE ACCOUNTING OFFICES DO
NOT ACCEPT KPC DEFERMENT FORMS IN LIEU OF PAYMENT BY PUBLISHED PAYMENT DEADLINES.
ATTENTION: THIS DEFERMENT IS A DEBT THAT MUST BE REPAID
I understand that any tuition, fees, and books I am charging against my financial aid become my responsibility should my aid not be
or
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ol
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le
s,
n
approved. If I become ineligible for aid, I will, by the end of the second week of classes, either: 1) Cancel my registration in person
via UAOnline, or 2) Pay all tuition and fees from my own funds. If I fail to drop or pay tuition & fees in full, I will be responsible for th
total amount due, plus any late fees and collection costs incurred by the University. In the event that I decide to withdraw from scho
for any reason, I will officially withdraw by completing the necessary forms in person or online. I understand that a partial or comple
drop after the 2
nd
week of the full semester may not result in a refund to me or to any funding agency. (See dates in the class schedu
for refund period.) In addition, adding additional credits after the 2
nd
week of the full semester may not increase your award amount
and you may be responsible for additional expenses. By signing below, I acknowledge that I agree to these terms. * Distance Educatio
textbooks are not eligible for deferment and must be paid out of pocket.
Student Signature ____________________________________ Date __________________________
Office Use Only
Application Status: Complete // Admit Pending ---- Incomplete Items Outstanding
Pell Grant $ _________ ASE Loan $ __________ Tuition Waiver $ ___________
SEOG Grants $ _________ Scholarships $ __________ Scholarship Type : ___________
Stafford loan $ _________ Other Aid $ __________ Other Type: ________________
FAO Approval: _______________________________________ Date: ___________________________
Notes:
______________________________
UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination.
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