SUMMER 2019
CHANGE IN ENROLLMENT FORM (R2T4)
Summer FAchange19
RETURN TO: Student Ser vices Ctr . 250
Financial Aid and Scholarship Office
Chico, CA 95929-0705
Phone: 530-898-6451 Fax: 530-898-6883
E-mail: finaid@csuchico.edu
Web site: www.csuchico.edu/fa
Last Name:
Chico State ID:
E-Mail: Date of birth:
MM / DD / YYYY
Summer Address:
First Name:
Phone:
REVISION TO SUMMER SESSION ENROLLMENT
*List all of your summer courses, not just new adds or drops!
Add / Drop
/ Enrolled
Subject (e.g., CHEM 107) Section
(e.g., 701)
Summer Course Dates (e.g., 6/3/19-6/27/19) Units
Please read and certify your application by checking the statements below.
All information provided on this form is true and complete to the best of my knowledge.
I understand that my aid may be adjusted or cancelled, and I may be required to repay aid based on the revisions in my
summer enrollment.
If my enrollment plans change, I will notify the Financial Aid and Scholarship Office immediately.
I will update my current mailing/local address on my Student Center, if necessary.
____________________________________________________
__________________
Student Signature Date
Federal regulations require that you attend and complete all your scheduled courses for the summer 2019 term. Your
scheduled summer courses are all courses in which you have enrolled and for which you have been funded. If you do not
begin attendance or your class is cancelled or you cease to attend any of your scheduled courses, you may have to repay
funds you have received for your summer enrollment. Attendance in a future 2019 summer session may nullify your
repayment requirement. If you plan to add a future 2019 summer session, you must indicate the session information
below in addition to courses in which you are currently enrolled or dropping.
Note: Failure to begin attendance in the futur e session will result in repayment of funds. The date you originally
signed this form will be used to calculate your repayment amount.
California State University, Chico
Chico, CA 95929-0705
Financial Aid and Scholarship Office
E-mail: finaid@csuchico.edu
Phone: 530-898-6451 Web Site: www.csuchico.edu/fa
Fax: 530-898-6883 Facebook: www.facebook.com/ChicoStateFASO
Total Summer Units
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signature
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