NORTH CENTRAL TEXAS COLLEGE
OFFICE OF FINANCIAL AID
Please return the completed form to one of our campuses. You may drop it off, mail it, or fax it.
Gainesville Financial
Aid Office
Corinth Financial
Aid Office
Flower Mound
Financial Aid Office
1525 W. California Street
STUDENT NAME: _________________________________ ID#: ___________________________
PHONE NUMER: _________________________________ DATE OF BIRTH: __________________
STUDENT REQUEST TO CANCEL FINANCIAL AID
I request that my Financial Aid at North Central Texas College be canceled for the following semester(s)
(please select at least one):
________ Fall ________ Grants Academic year: ___________________
________ Spring ________ Loans
________ Summer ________ Other
Briefly explain the reason for this request:
______________________________________________________________________________________
______________________________________________________________________________________
Please read the statement below. Please initial on the line if you agree:
______ I understand that canceling my aid may result in unpaid charges for classes for which I registered. I will be responsible for
paying any outstanding balance in the Business Office. A hold will be placed on my account for unpaid charges until I pay
them.
Signature: ____________________________________________ Date: ____________________
Financial Aid Office Use ONLY
Form received by: ___________________________________________ Date received: __________________________
Aid Canceled: __________ Pell Grant
__________ SEOG
__________ TPEG
__________ Texas Grant / Texas Grant II
__________ Work-Study (unearned portion)
__________ Direct Subsidized Loan
__________ Direct Unsubsidized Loan
__________ VA Benefits/Hazlewood
__________ Other: __________________________________
Date Canceled: _____________________________________ Signature: _____________________________________________
Date Canceled in COD: _______________________________ Signature: _____________________________________________
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