Fillable Improper Withdrawal/Refund Appeal (University of Nevada, Reno)

Fill Online, Printable, Fillable, Blank Improper Withdrawal/Refund Appeal (University of Nevada, Reno) Form

Use Fill to complete blank online UNIVERSITY OF NEVADA, RENO pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Improper Withdrawal/Refund Appeal (University of Nevada, Reno)

On average this form takes 6 minutes to complete

The Improper Withdrawal/Refund Appeal (University of Nevada, Reno) form is 2 pages long and contains:

  • 0 signatures
  • 7 check-boxes
  • 20 other fields

Country of origin: US
File type: PDF

U.S.A. forms for University of Nevada, Reno

BROWSE UNIVERSITY OF NEVADA, RENO FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Office of Admissions and Records
University of Nevada, Reno/Mail Stop 0120 - 775-784-4700 - Fax: 775-784-4283
Improper Withdrawal/Refund Appeal
Students who need to drop a course(s), withdraw from a semester, or request a refund after the drop/refund deadlines
have passed may appeal the process, if there are extenuating circumstances beyond the control of the student.
Extenuating Circumstances Example:
- Student becomes ill during the semester and is unable to complete courses.
Appeal Procedures
1. Improper Withdrawal/Refund Appeal Form
2. Signed letter of intent that outlines the specific request. This letter should include concise and relevant
information regarding the situation and the course of action requested.
3. Documentation that supports the request.
The appeal will not be processed until sufficient documentation is provided, for example, a letter from a
doctor or therapist, police report, etc. The University of Nevada, Reno reserves the right to request
additional information when deemed appropriate.
Once all required paperwork is in order, the request is forwarded to the Student Withdrawal/Refund Appeals Board. If
approved by the Board, the request is then forwarded for final academic approval to the instructor, chair and dean for
each course or the dean of the student's major program.
Students will receive written notification regarding the results of the appeal outcome.
The appeal outcome is final. There are no further appeals for the improper withdrawal/refund process.
Decisions of the Board may include one of the following:
• 100% refund of registration fees paid; courses are removed from the student's transcript
• 50% refund of registration fees; grades of W (withdrawal) are received for the courses
• Withdrawal only - no refund
• Denial
To return to the University at any time after the withdrawal semester, you will need to complete the Returning
Financial aid recipients must obtain counseling from a financial aid officer regarding the impact of dropping courses
or a total withdrawal on a student's financial aid status. Students receiving financial aid/scholarships who withdraw
from a course(s) may have their aid adjusted and may be required to repay some or all of the aid received.
Please be aware that it is the responsibility of each student to clear all financial obligations with the University.
Submit the following documents to: Lori Tiede
Appeals Coordinator
Office of Admissions and Records/Mail Stop 120
(Fitzgerald Student Services Building, 2nd Floor)
(775) 682-5910
ltiede@unr.edu
Office of Admissions and Records
University of Nevada, Reno/Mail Stop 0120 - 775-784-4700 - Fax: 775-784-4283
Improper Withdrawal/Refund Appeal
I have provided a letter of intent explaining my extenuating circumstances and substantiating documentation of my situation.
I hereby authorize Admissions and Records to release my confidential information, resulting from contact with the staff of
Admissions and Records.
I understand that information regarding my withdrawal/refund request will be heard by all members of the Student Withdrawal/
Refund Appeals Board. The Board members will not release confidential information from their meetings and the original student
file will be returned to Admissions and Records for safekeeping.
I understand that I am under no obligation to disclose the requested information and am releasing the information voluntarily. I
may revoke this consent at any time by informing Admissions and Records in writing of my intent. Further, this consent shall
expire after a period of 90 days from the date of my signature below.
In consideration of this consent, I hereby release the above parties from any and all liability. I also acknowledge by signing this
form that I may be required to repay some or all of the Financial Aid received for the term(s) in question if the appeal is approved.
By signing below, I acknowledge acceptance and understanding of the terms listed above. I certify that the
information in this appeal is true, accurate and complete.
Name
NSHE ID
Signature
Date
Requested Action:
Total Withdrawal from Classes
Partial Withdrawal from Classes
Change to Audit
100% Refund*
50% Refund (only granted for withdrawal
from all courses of the semester)*
* Refunds may require student to repay
some or all of Financial Aid received for the
term(s). Contact the Office of Financial Aid
with questions.
Semester/Year Requested Courses Last Day of Attendance
For Office Use Only
Approved
Denied
Date
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Improper WithdrawalRefund Appeal (University of Nevada, Reno)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 30 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document