4/8/2020
SC4 Academic Success/Financial Aid Appeal Form
Step 1 Student General Information
Student Name Student ID
Student Address
Phone Number Email Program of study
Last semester attended
Semester for which appeal is being considered: Fall Winter Summer
Type of Appeal (Check all that apply): Academic Success Financial Aid
Students placed on Academic Success or Financial Aid Termination may appeal for the ability to register for
classes and/or receive reinstatement of financial aid when extenuating circumstances exist. Appeals are
reviewed by Student Services representatives as well as input from academic administrators when appropriate.
Lack of awareness of withdrawal policies, requirements for satisfactory academic progress or unpreparedness
for college coursework, will not be accepted as reasons for the purpose of an appeal.
You must:
Submit a personal statement explaining why you failed to achieve satisfactory academic progress. The
statement should include any relevant factors such as illness; unusual demands upon you due to family,
work, or life circumstances; and your perspective on what led to this academic difficulty. Address all
periods of enrollment in which you failed to maintain academic progress.
Explain how your circumstances have changed, allowing you to successfully make satisfactory progress.
Include resources you intend to use to assist you in becoming successful.
Submit third-party documentation supporting your appeal, if appropriate. Documentation may include a
doctor’s statement, copy of hospital/urgent care/physician’s bill, obituary, funeral notice or death
certificate. If excessive work is a factor, obtain a letter from your employer outlining the job demands or
work schedule.
Students submitting an Academic Success Appeal only: Complete Step 2
Students submitting a Financial Aid Appeal must Complete Steps 2 and 3
Step 2 My unsatisfactory progress is due to (check all that apply):
GPA Requirement/Pace: I currently have a cumulative grade point average (GPA) below a 2.0 and/or
cumulative completion rate that is less than 67%. GPA and completion ratio can be found on your portal
account.
Grade Point Average:
Completion Ratio:
Maximum Time Frame Requirement (for Financial Aid Appeal): I have exceeded 150% of attempted credit
hours needed for my specific program and have reached the maximum time frame level. I am including the
Academic Progress Review form the SC4 Academic Advisor completed for me when I met with the Advisor. If you
do not have your Academic Progress Review, stop, you must get one completed prior to filing this Maximum
Timeframe Appeal. Contact the Advising Office at 810.989.5520 to schedule an appointment to have one
completed.
Year you started this Program of Study:
Semester in which you will complete this Program of Study:
Total number of all credits attempted at SC4:
Federal regulations prohibit students from receiving funding after they have attempted 150% of credits needed
for a degree. If your appeal is due to Maximum Time Frame (Time Limit), your appeal must:
o Include your Academic Progress Review Form
o Include why you feel an exception should be made for you
o Include what your ultimate college and career goals are
Note: If your appeal is approved, aid can only be used to pay for courses required for your degree or eligible
program.
Step 3 Financial Literacy (for Financial Aid Appeal only)
List your total loan debt: Go to https://nslds.ed.gov to obtain this information. Please attach a copy of the loan
debt statement to this form. $
Statement of Understanding
Please read and place a check mark next to the following statements indicating you understand the importance
of each:
I am currently ineligible for financial aid and am responsible for any tuition and fee charges.
A small percentage of appeals are approved.
This appeal will be reviewed by a committee and the decision is final.
I should purchase my books and supplies by the first day of the semester.
I will attend all regularly scheduled classes for each course.
Free tutoring is available for most courses in the Achievement Center.
Academic Advisors are available to help me prepare my class schedule each semester and assist in
completing a Program Completion Plan in the Student Success Advising Office (TRIO students will contact the
TRIO Advisor or Director for assistance with completing this Academic Success/Financial Aid Appeal form)
Financial Aid Officers are available to help me investigate possible financial resources.
Student Development courses such as College Success and Career Development are available.
Dropping a course after the refund period will negatively impact my completion ratio.
If my GPA Requirement/Pace appeal is approved, I must earn a minimum 2.0 semester GPA and successfully
complete 75% of the semester courses attempted (includes W, I, E or Z grades).
If my Maximum Time Frame Appeal is approved, I must earn a minimum overall 2.0 grade point average and
complete 100% of the courses attempted each semester on time to maintain eligibility (no W, I, E or Z grades).
Incomplete appeals will not be considered. Submission of this appeal form does not guarantee approval. The
Academic Success/SAP Appeals Committee will notify you in writing of the final appeal decision.
Student Signature Date
If you are able, please print and physically sign this form. If you do not have access to print, please type your name above,
but you will need to come into the Financial Aid office once we re-open to sign.
4/8/2020
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