Student Finance Appeal Form
Electronic form instructions
This form can be completed just as you would a paper document. The two main questions
on this form will automatically expand to the length of your request.
Submission instructions
Once the Appeal Form is completed please print then sign the form. You can then either
mail or fax the document to us.
Mailing address Fax Number
Student Finance 423.236.1894
PO Box 370
Collegedale TN 37315
Email address
studentfinance@southern.edu
Deadline for submitting appeal form
The deadline for submitting an appeal to the committee is 12 p.m. on Monday for it to
appear on the agenda for the current week. The committee meets most Wednesday mornings
depending on number and urgency of the appeals received by that time.
Response from committee
A copy of this form along with the committee decision will be mailed to you.
Student Finance Appeal Form
Financial Appeals Committee I.R.P. (Tennessee Hope Scholarship
Appeal)
Before your appeal will be considered, a student will need to:
Submit a completed appeal form with any supporting documentation.
Meet with your Student Finance Counselor.
If applicable you may need to complete the FAFSA process or the International Student Aid Application; accept all
types of financial aid offered, including parent loans (if eligible) and subsidized/unsubsidized loans; and/or allocate at
at least 75% of your work funds to your student account.
STUDENT INFORMATION
Name: Student ID:
Mailing address:
Phone #:
Cell phone #:
Do you live?
E-mail:
Current class standing:
APPEAL
On Campus Off Campus
Freshman Sophomore Junior Senior Masters
Current major:
Current cumulative GPA:
Current unpaid balance:
What is your request to the committee and the rationale for this request? (Please include your financial plan,
particularly what you and/or your financial sponsor(s) will be doing to help with your situation and any
special circumstances.)
Employed by: Hours Per Week: Wage:
How much have you paid on your account?
How much will you and/or a sponsor contribute for the rest of the semester?
Date auto adds upon printing
STUDENT SIGNATURE:
Student Finance Counselor Signature
Date:
Date:
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