FINANCIAL AID OFFICE | 500 Newtown Pk Lexington KY 40508 | | P 855.246.2477
Financial Aid Cancellation Form
ID# Last First
ORI: <FA - General Financial Aid> <FA General Financial Aid Misc
Have you totally withdrawn from all of your courses?
STUDENT CERTIFICATION: By signing this form, I affirm that the information I am providing is true to the
extent of my knowledge; I also understand that if I intentionally give false or misleading information on any
financial aid documents, I may be fined, sentenced to jail, or both.
I want to cancel the following aid offer(s):
Cancel ALL of my Financial Aid
Federal Pell Grant
FSEOG (Federal Supplemental Educational Opportunity Grant)
Federal Work-Study
Direct Subsidized Loan
Direct Unsubsidized Loan
PLUS (Parent Loan for Undergraduate Students) Loan
Alternative/Private Loan
CAP (College Access Program) Grant
KEES (Kentucky Educational Excellence Scholarship)
If you have total withdrawn, what was your last date of attendance?
Why are you cancelling your financial aid?
Are you returning a refund check?
Signatures Date
Cancel aid for the following term(s):
Fall 2020
Winter 20-21
Spring 2021
Summer I 2021
Summer II 2021
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