Fillable TUITION REFUND REQUEST (Walla Walla University)

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TUITION REFUND REQUEST (Walla Walla University)

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TUITION REFUND REQUEST
To
Finance Committee
Name: ______________________________________________ ID# :__________________ Date:_______________________
Last First Middle
Local Address:_____________________________________________________ Phone #:______________________________
Village Box or Dorm
Class Level_____________________ Class withdrawn________________________________ Quarter Taken______________
State briefly the request and the reasons for this request. Return the completed form to the Academic Records office.
_____________________________ _________________________________
Student’s Signature Academic Advisor’s Signature
COMMITTEE RESPONSE:
_______________________________________
Finance Committee Date
Date of withdrawal:______________________
Total credits before change:________________
Total credits after change:_________________
Refund given No YES________________
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TUITION REFUND REQUEST (Walla Walla University)

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Completed 2 February 2021

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