Rev. 3/2020
Indian River State College
Office of Financial Aid
3209 Virginia Avenue Fort Pierce FL 34981
Phone: (772) 462-7450
Fax: (772) 462-4606
Enrollment Pattern Review Form
Student Name: Last: First: Middle:
IRSC Student ID:
Your 202021 Free Application for Federal Student Aid (FAFSA) has been flagged for “Unusual
Enrollment History” by the U. S. Department of Education because you received Federal Pell Grant
funds at multiple education institutions during the review period 2017-2018, 2018-2019, and
2019-2020. This flag requires IRSC to review your enrollment history and determine your eligibility
to receive federal student aid. In the process of reviewing your enrollment history, IRSC will check
the National Student Loan Data System (NSLDS) to obtain a complete history: the name of
institutions you have attended, and the dates of attendance. Please visit and click on “financial aid
news” for more details regarding Unusual Enrollment History flags.
Please complete the steps below. Your application for financial aid will not be considered until
you submit this completed form and required documentation. You will be notified via email of our
decision within 30 days of completing these requirements.
STEP 1: Submit or request for an official sealed academic transcript for any colleges previously
attended to be sent to the IRSC Admissions & Records office. PLEASE DO NOT TURN THIS
FORM IN UNTIL ALL TRANSCRIPTS HAVE BEEN RECEIVED.
STEP 2: List below the name of all education institutions you attended during the review period
2017-2018, 2018-2019, and 2019-2020. If you need additional space, please attach a separate
page. Include your name and ID at the top of each page.
1. 2.
3. 4.
5. 6.
Rev. 3/2020
STEP 3: If you did not earn academic credits at any of the above schools during the review period
2017-2018, 2018-2019, and 2019-2020, attach a statement explaining the reason for your failure
to earn any academic credit at that institution. Attach any relevant documentation (i.e., medical
bills, hospitalization records, accident reports, etc.) and include your name and ID at the top of
each page.
By signing below, I certify that the information submitted on and with this form is accurate
and complete.
Student’s Signature: Date:
Upload your form to your MyPioneer Portal
FOR OFFICE USE ONLY
Reviewed Date: Reviewed by:
All transcripts received Credit was earned at each institution
No other concerns Transcript/s missing
Credit not earned Other:
Clear Flag Deny Aid
click to sign
signature
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