Financial Aid Office, 2755 E. Napier Avenue
Benton Harbor, MI 49022
Email: Fax: (269) 927-8183
factory Academic Progress Appeal Form
Appeal Deadline: Your Satisfactory Academic Progress (SAP) appeal must be received by the deadlines listed below; check the
appropriate term of your appeal.
Fall Semester
Deadline: August 30
Spring Semester
Deadline: Jan. 6
Summer Semester
Deadline: May 5
Are you currently attending LMC: NO YES Last semester you attended at LMC: _____________________
Step #1: Student Information
LMC Student ID # Student’s Last Name Student’s First Name MI
Address City State Zip
Program of Study
Phone Num
l Address (other than school email)
To support you and m
ake sure that you are meeting academic progress standards,
students are required to meet with their Academic Advisor for a mid-term check-in
while on WARNING. Did you meet with your Advisor in the previous semester that
you were placed on WARNING for a mid-term check-in?
Students have the right to appeal the loss of financial aid due to not meeting the Satisfactory Academic Progress Policy. The U.S. Department
of Education regulations (34 CRF 668.34) state that you must meet one of the following criteria to appeal your suspension from financial aid:
(1) Death of a relative of the student; (2) Injury or illness of the student; (3) Other circumstances that result in undue hardship to the student
Step # 2: Schedule an Appointment with your Academic Advisor
IMPORTANT: Set up an appointment to discuss your Student Success Plan with your Academic Advisor by calling 269-927-8128.
Step # 3 : Personal Statement and Documentation
e answer the following questions. Use a separate sheet of paper. A one-sentence response is not acceptable.
1. Explain the extenuating circumstances that prevented you from meeting the Satisfactory Academic Progress standards and what has
changed to allow you to meet SAP standards at your next evaluation period. (Refer to the Satisfactory Academic Progress Policy on
our webpage).
2. Provide third-party documentation on professional letterhead to support your appeal. A third party is someone not related to you
(clergy, social worker, caseworker, counselor, doctor) who is familiar with your situation and can support the reason for the appeal.
See the back side of this form for examples of acceptable types of third-party documentation that can be used to substantiate the
basis of your appeal.
Student Certification
I certify that all information and documentation I have submitted pertaining to this appeal is true and accurate.
I understand that the decision of the Financial Aid Appeal Committee is final.
________________________________________________ XXX-XX-_____________ _________________________
Student Signature Last 4 digits of SSN Date
click to sign
click to edit
Documentation (please provide at least one of the
Medical Condition
(Any letter(s) should state the nature
of your illness/injury, the date(s) of
occurrence, and that you are able to
return to school.)
*Letter stating doctor advised period of recovery
*Record of doctor visits
*Hospitalization records
*Copies of medical bills documenting illness/injury
Mental Health Issue
*Letter from doctor, therapist, or counselor
Dental Emergency
*Record of dental visits
*Letter from dentist
*Letter stating dentist advised period of recovery
Student’s Children
Child’s Medical Condition
*Records from daycare/school that child was required to be
kept home (include in appeal the reasons that alternative
care was not available and what the plan is if this should
occur in the future)
*Records from doctor visits
*Letter stating doctor advised period of recovery
*Hospitalization records
Daycare Issue
*Letter from former daycare provider
*Letter from new daycare provider
Additional Circumstances
Death of a Loved One
*Funeral program
*Death certificate
*Letter from counselor
*Documentation should include date and indicate
relationship to the deceased
*Eviction notice
*Letter from transitional housing program
Assault/Domestic Abuse
*Police report
*Court documentation
*Letter from clergy, social worker, counselor, doctor
- Submit your appeal form and supporting documents to the Financial Aid Office or email your complete packet to:; ensure all documents supporting your claims are attached to this appeal.
- The Appeal Committee reserves the right to deny your SAP Appeal for unsubstantiated extenuating circumstances.