Tuition Appeal Form
Complete this form and submit to the Tuition Appeals Committee, Student Services, Community College of Rhode Island,
400 East Avenue, Warwick, RI 02886, Or fax to 401-825-1148, Or email firstname.lastname@example.org
Be sure to include appropriate documentation (see below)
Falsifying information on this Appeal will result in immediate denial and may be grounds for sanctions as outlined under the
Student Code of Conduct
Name Student ID #
Email Address Phone Number
Semester appealing for: Spring ___ Summer ___ Fall ___ Year ______ Receiving Financial Aid: Yes ___ No ___
Specify Request: Tuition Refund _____ or Balance Waiver _____
Check Reason for Appeal
Student Illness: A note from your physician or medical provider on their letterhead indicating the dates you were unable to attend
class. The note must be signed by your physician or medical provider. Excuse slips, copies of invoices, appointment confirmations,
statements of insurance payments, etc. are not acceptable documentation. Do NOT send copies of your medical records.
Illness of immediate family member: A note from your family member’s physician or medical provider on their letterhead indicating
the dates of illness and the need of a caregiver. The note must be signed by the physician or medical provider. Excuse slips, copies of
invoices, appointment confirmations, statements of insurance payments, etc. are not acceptable documentation.
Death of immediate family member: Submit a death certificate, obituary or death notice. Documents must clearly indicate the
relationship of the deceased to the student. (Immediate family is defined as: parent, grandparent, sibling, child, spouse)
Military deployment: A copy of the official deployment/reactivation notice. Deployment and reactivation dates must be within the
semester you are appealing.
Change in employment beyond the student’s control that prevents the student from attending the classes for which he/she is
registered. A letter from your employer on company letterhead indicating the reason and date of the change in work schedule.
Verifiable Error of CCRI: Provide a detailed account of the problem and relevant documents on College letterhead from the College
Office involved or advisor indicating that incorrect information was given by a College representative.
Other: Provide a detailed account of the extenuating circumstance and submit copies of supporting documentation.
COVID-19 related reason: (Spring 2020 only) loss of income (provide employer verification or proof applied for UE benefits); increased
work hours (provide employer verification of new hours); loss of childcare or assisting your school age children with their online learning
(provide copy of child's birth certificate)
Attached to this (1) Appeal Form is (2) my Letter of Explanation clearly explaining what caused my inability to attend the term in
question, and (3) copies of the appropriate Supporting Documentation. The responsibility for ensuring that Community College of
Rhode Island has received the needed documentation rests with the student filing this Appeal.
By signing this Appeal I acknowledge that I am responsible for withdrawing from my class(es), the committee will not
I understand the Tuition Appeals Committee will notify me by email of their decision regarding my appeal, decisions will
NOT be given over the phone.
I have reviewed the information contained in this document and BY SIGNING BELOW, I UNDERSTAND THE IMPLICATIONS
OF MY APPEAL.
Student Signature Date
DO NOT WRITE BELOW THIS LINE
Pending Additional Documentation
Committee Member Signature Committee Chair Signature