Appeals are reviewed for students who fail to meet federal and/or institutional financial aid
requirements for Satisfactory Academic Progress and who can demonstrate that this resulted from
extenuating circumstances beyond their control. Please submit this appeal form, along with all
supporting documentation, to the Financial Aid Office.
Name______________________________________________ __ID #_________________________
INSTRUCTIONS - Check the circumstance(s) which prevented you from making satisfactory academic
progress in Section 1 and provide the additional information requested. Then complete Section 2.
Section 1: Basis for Appeal
(A) ____ Illness or Injury: You (the student) or an immediate family member were injured or ill for an
extended period of time. Please attach a copy of a statement from the physician (students only, not family
members) and provide the following information:
Name of the Ill/Injured________________________________________________________________
Nature of Illness/Injury ________________________________________________________________
Name of Physician_____________________________________________________________________
Date(s) of Illness/Injury_________________________________________________________________
(B) ____ Death in the Immediate Family: Please attach a photocopy of the death certificate, or death
announcement listing surviving family members, and complete the following information:
Name of Deceased____________________________________________________________________
Relationship to You ____________________________Date of Death____________________________
(C) ____ Other Extenuating Circumstances: You (the student) experienced some unusual circumstance
not listed. Explain the extenuating circumstance and how it prevented you from making satisfactory
academic progress on the following lines, and attach supporting paperwork, as appropriate. If your
Satisfactory Academic Progress issue developed over the course of several semesters, you must explain
the circumstances of each semester. Feel free to submit an additional page if you need more space.
Extenuating Circumstances Explanation
Section 2: Ensuring Future Success
Please explain what you have done or will do to resolve the issue(s) that prevented you from making
satisfactory progress. Be very specific. There must be sufficient reason to believe that you will be able to
make satisfactory progress in the future. Feel free to submit an additional page if you need more space.
Student Signature___________________________________________Date______________________
Submit via ONE of the following:
Mail-Financial Aid Office, 400 Cedar Avenue, West Long Branch, NJ 07764