Loss of BOGW Appeal 17-18
(You are completing this form because you lost your Board of Governors Fee Waiver due to your academic status)
OFFICE OF FINANCIAL
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1570 E. Colorado Blvd. Room L-114, Pasadena, CA 91106
Stud
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: Stud
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INSTRUCTIONS:
1. Complete the following form in the lines and boxes designated below (attach a separate sheet, if needed).
2. Provide a Comprehensive Student Educational Plan (CSEP) completed by your PCC counselor.
o Bring this completed form with you to your counseling appointment. If you are a CalWORKs, EOPS, or Veteran student you must
meet with a Counselor from that program to obtain your CSEP and program verification.
3. Attach all required supporting documents to this appeal form.
4. Submit this completed appeal packet to the Office of Financial Aid by the deadline printed below.
5. If you have not already done so, please complete the BOGW application or FAFSA.
6. You will be notified of the results by email to your LancerPoint email account.
APPEAL DEADLINES: Glossary of Terms:
Fall 2017: December 15, 2017 CSEP: Comprehensive Ed Plan
Winter 2018: February 16, 2018 BOG: Board of Governors Fee Waiver
Spring 2018: June 15, 2018 Accommodation: A student with a disability who has worked with a counselor to identify
Summer 2018: July 13, 2018 a need such as extra time on tests, etc.
APPEAL PROCESS:
Appeals are reviewed individually in the order they are received. Please include all information or we will have to put your appeal aside and not
make a decision. An email notification will be sent to your PCC LancerPoint address with the results. Circumstances below marked with an * may
require additional review and may take up to 2-3 weeks for a decision.
Appeal Term/Year: Fall 2017 Winter 2018 Spring 2018 Summer 2018
BOGW Loss - Reason for Appeal: Check the box of each reason you are
app
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.
Academic and/or Progress Improvement. The student must demonstrate significant academic improvement by achieving the
minimum grade point average of 2.0 and 50% completion of units attempted in the most recent primary term.
No Enrollment for Two Primary Terms. Approval requires the student was not enrolled at any PCC location for two consecutive
primary terms (fall/spring) since becoming ineligible for the BOG.
*Special Consideration for CalWORKs, EOPS, DSPS, and Veterans. The student must provide written documentation from one of the
included programs indicating current level of participation and services provided. Explain the circumstances below.
Untimely
Accommodation.
The student must have a disability, and applied for but did not receive
accommodations
in a timely manner.
Explain the circumstances below.
*Extenuating Circumstances. Approval requires verified evidence of circumstances beyond the students control. This could include:
death of an immediate family member, accident, serious illness, eviction, etc. The student must provide documentation such
as
: medical
documents, death certificates, police reports, court documentation, etc. Explain the circumstances below.
*Inability to Obtain Essential Support Services. The student must provide documentation, such as: cancelled appointment notices,
emails, text messages, and statements from professionals on letterhead. Explain the circumstances below.
*Economic Situation. Approval requires verified evidence of an economic situation such as: job loss, eviction, and homelessness,
etc. To be considered, the student must provide documentation, which may include: eviction notice, layoff/termination notice,
unemployment statements, etc. Explain the circumstances below.
Use the space below for written explanations. Attach additional sheets if necessary.
BOGW Appeal, page 1 of 2
STUDENT CERTIFICATION Read the following information and sign below:
I certify the information contained in this appeal form, supporting documentation, and statements of circumstances are accurate
and complete to the best of my knowledge and any false information will be cause for denial.
Signature: Date:
OFFICE USE ONLY COUNSELING STAFF:
CSE
P
Compl
ete Initials:
D
ate:
OFFICE DETERMINATION:
Academic/Progress Improvement Final Semester High Unit Major No Enrollment 2 terms Untimely Accommodation
BOGW Approval Needs Committee Review
Review
er’s Si
g
natu
re: Date:
F
A
O
N
otification
Date:
BOGW Appeal, page 2 of 2
Student’s Last Name: Stud
ent ID:
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