04/2019 Student Accounting Services
STUDENT FINANCIAL PETITION
Use this form to request the reversal of a tuition charge. Golden Gate University (GGU) will only reverse a charge if you present evidence of a serious
and unexpected circumstance beyond your control which prevented you from attending a course or paying its tuition. You must attach documentation
verifying this circumstance, such as a letter from a physician with a license number. (Such letters need not provide any details beyond dates of
treatment and expected recovery.) This documentation becomes the property of GGU and will not be returned. The petition and all of its information
will remain confidential, and only be seen by members of the Committee on Student Financial Petitions, which is composed of representatives from
the offices of Academic Affairs, Admissions & Student Affairs, Records & Registration, and Student Financial Services. If the committee needs to
approach other members of the university to investigate or verify the claims made in the petition, it will first obtain your permission.
The committee will consider your petition ONLY if you meet the following 4 conditions: 1) A petition letter is included; 2) You have dropped
the course or received a “W” or a “F” grade with Last Date of Attendance (LDA) prior to the end date of the class; 3) Supporting
documentation is sufficient and 4) We receive this petition within 60 calendar days of the last day of the course.
Submit petition to: Or fax it to:
Golden Gate University (415) 442-7819
Committee on Student Financial Petitions
Office of Student Accounting Services
536 Mission St. Questions? Call the Committee Coordinator: (415) 442-6544
San Francisco, CA 94105-2968
Class for which you want the tuition charge reversed: (ALL FEES ARE NON-REFUNDABLE)
Term
(e.g. 19/FA): ______________ Number (e.g. MGT 300): ____________________ Campus Location: ___________
Did you receive Federal Aid or Veterans Educational Benefits for the term(s) listed above? ❑ Yes ❑ No
If you checked “Yes” above, please attach an email statement from that office indicating that you have reviewed with
them any financial implication or further eligibility this may cause.
I acknowledge that if this petition is approved and my tuition charge is reversed, and I received Federal Student
Aid or Veterans Educational Benefits, I authorize the funds be used to reduce outstanding loans (to the
Department of Education) or to pay a debt letter to the VA. ______________________________
(student signature)
GGU ID Number: _____________________ _____________________________________________________
Last name First Name
E-mail Address: ____________________________________ Daytime Phone: _______________________________
Mailing Address: _________________________________________________________________________________
Street City State Zip
Attach both:
1) A sheet on which you explain the extenuating circumstance
(typed or legibly printed, and including only relevant details);
2) Verifying documentation.
The University will respond to all petitions in writing. You should allow a minimum of 30 working days to hear from
the Committee after your submission. The decision of the committee is final and binding. Appeals will only be heard if
they include information and/or documentation not included in the original petition.
If you have a documented disability (as defined by the Americans with Disabilities Act of 1990 and/or Section 504 of
the Rehabilitation Act of 1973) contact GGU’s Disabilities Services Coordinator in the Office of Admissions & Student
Affairs at (415) 442-7863. The coordinator will assist you in planning course accommodations in the future.
Your signature below indicates that you have read and understand the information on this form and confirm that your
petition is true and accurate.
Student Signature: __________________________________________________________ Date: ________________
❑ Approve ❑ Deny Date: ______________ Initials of committee members: ________ ________ ________ ________ ________
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