Petition to Remove a Late Payment Fee
Instructions: Please print or type clearly. Complete all sections of this form and sign. A decision will be emailed
directly to your Fuller email account within 15 days of receipt of a complete Petition by Student Financial Services.
1. Did you use Online Registration to register for your courses? Yes No
2. If you registered online, did you complete each of the Registration Steps? Yes No
If you answered “No” to Question 2, please explain why you were unable to complete each of the Online
Registration Steps.
3. Please use the space below to explain the extenuating circumstances that prevented you from paying your
remaining balance due in full or signing up for the Fuller Tuition Payment Plan by 4pm on the first Monday of the
Name: ID:
Phone Number: Fuller Email:
Signature Date
Certification: The information provided above is true and correct. I understand that the Late Payment Fee may be
removed upon approval of the Petition Committee and that additional petitions or requests for the removal of any
subsequent Late Payment Fees charged to my student account will not be granted.
Petition Committee Disposition Banner Updated
Approved: Yes No By: Date: By: Date:
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