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SCC Financial Aid Use Only
Approved____ Date/Initials __________
Denied___ Date/Initials _____________
SOUTHEASTERN COMMUNITY COLLEGE
FINANCIAL AID OFFICE
2020-2021 REQUEST FOR REVIEW OF UNUSUAL ENROLLMENT HISTORY
______________________________ __________________ _____________________________________
Student’s Last Name, First Name Student’s ID or SSN Student’s Date of Birth
Student’s Street Address, City, State and Zip Code
Student’s Email Address
Student’s Home Phone Number Student’s Cell Phone Number
Semester you are planning to attend __________________
Your financial aid application has been flagged by the Department of Education because your enrollment pattern over the
last couple of years indicates that you have been enrolled at several different colleges and received federal financial aid.
In this case, a student must provide documentation to the SCC Financial Aid Office as follows:
1) Official college transcripts from any previous college attended.
2) Complete this Enrollment History form and provide written statement of any special circumstances as noted
below. Documentation from a third party is required to support your circumstance.
These circumstances must be one of the following:
Death in the family
Medical Illness (Personal/Immediate family)
Divorce or Separation
Change in where the student is living
Other Academic circumstances:
Academic program not meeting student’s needs
Unexpected academic challenges.
Complete the reverse side of this form, providing a detailed statement of the extenuating circumstances for each
period of enrollment that you did not earn any academic credit at the prior college. Please include:
What specifically happened that caused you not to complete your classes?
When did the above occurrence happen (month and year)?
How did the above occurrence affect your academic performance?
Briefly explain what has now changed, or the steps you have taken, that should now result in you completing your
classes in the future.
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