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525 SOUTH MAIN STREET • ADA, OH 45810 • (419) 772-2010 • FAX: (419) 772-2778 • www.onu.edu • controller@onu.edu
Controller’s Office
Request to Retain Credit on Account
Student’s Name: ______________________________________
Student’s ID #:
______________________________________
I wish to retain the credit balance on my ONU student account
FROM: ____/____/________ TO: ____/____/________
MM DD YYYY MM DD YYYY
• Please use today’s date as the FROM date.
• You can use any date you wish for the TO date. If you would like to roll your
credits from term to term until you graduate, you may want to use a week or two
into your estimated graduation term.
I understand that my credit balance will remain on my ONU student account for the
term specified only. I understand that if I wish to have this credit refunded, I will
need to revoke this authorization form by filling out the section below.
______________________________________________________________________
Student’s Signature Date
**REVOKE AUTHORIZATION**
By signing below, I revoke the authorization to retain the credit balance on my account
and request that it be refunded.
______________________________________________________________________
Student’s Signature Date
Rev. 4/1/2020
