Fillable Tuition Appeal Form Registration and Records General Information (Henry Ford College)

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Tuition Appeal Form Registration and Records General Information (Henry Ford College)

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The Tuition Appeal Form Registration and Records General Information (Henry Ford College) form is 4 pages long and contains:

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  • 12 check-boxes
  • 45 other fields

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File type: PDF

U.S.A. forms for Henry Ford College

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Registration and Records
Tuition Appeal Form
General Information
A Tuition Appeal should only be used for extenuating circumstances as outlined below.
Regardless of the appeal outcome ONLY ONE appeal is allowable during an academic career
at HFC. Therefore, if your circumstance does not meet the guidelines outlined below you
should not submit an appeal.
Appeals must be submitted within 10 business days after the end of the semester in which
your extenuating circumstance occurred. Appeals postmarked after this deadline will
automatically be denied with no exceptions given. Please refer to the HFC Academic Calendar
at hfcc.edu/academic-calendar to determine the deadline or final submission date in which you
must have your appeal submitted for review.
Only courses with the letter grade of “DR” or “W” will be considered.
Important deadline: Appeals will not be considered if they are older than one semester. Your
extenuating circumstances must have occurred within the semester in which you are appealing
requiring you to withdraw from all courses. Appeals that are incomplete (missing
documentation) or submitted after the 10 business day deadline will not be considered, and
result in an automatic denial. This will count as your one allowable appeal during your
academic career at HFC. Please make sure you meet one of circumstance requirements listed
below before submitting a tuition appeal.
There are only three circumstances in which appeals will be considered:
1. Student illness requiring hospitalization: This would be a serious illness that required you to
be hospitalized during the semester in which you are submitting an appeal. You are
required to provide official documentation from your attending physician on his or her
letterhead. The physician documentation is required to include the following information: a)
diagnosis; b) duration of illness; c) dates in which you were examined and/or treated in the
hospital; d) dates in which you missed class(es) due to hospitalization; e) the timeframe in
which you were allowed to return to classes at HFC after hospitalization. The physician
letter must be typed, include the attending physician’s signature, and his or her phone
number. Handwritten notes from a prescription pad are not acceptable.
2. Death of an immediate family member: An immediate family member is considered to be
your parent or legal guardian, spouse, sibling or child. You are required to provide proof of
relationship (birth certificate, marriage license) and the death certificate must be included.
Registration and Records
Tuition Appeal Form
3. Military deployment or reactivation: Students are required to submit a copy of the official
military deployment or reactivation paperwork.
Important information for students receiving financial aid: If you are dropping classes
during a semester in which you have received financial aid, HFC and/or you may be required
to return the aid to the Federal government, which may include all or a portion of the financial
aid that was disbursed and/or applied to your student account. Please contact Financial Aid
regarding the impact this appeal decision could have on your financial aid.
Student Responsibility upon Submitting an Appeal
1. Students are required to drop the course(s) in which they are requesting reimbursement for
prior to submitting their appeal.
2. Students are required to complete, sign and submit page 2 of this appeal form.
3. Students are required to type a letter with a detailed explanation of their extenuating
circumstance.
4. Students are required to submit all supporting documentation specific to their appeal
circumstance.
5. Students are required to submit the documentation listed below in their appeal packet
postmarked by the 10 business day deadline:
a. Page 2 of this appeal form (completely filled out and signed by the student)
b. A typed letter of explanation (from the student outlining the extenuating
circumstance in detail)
c. All required supporting documentation of the extenuating circumstance (physician
letter of hospitalization, death certificate, etc.)
6. Students should submit their appeal packet by the 10 business day deadline:
a. Place in the drop box located next to the Concierge Desk in the Welcome Center
b. Mail it to: HFC, Office of Registration and Records, ATTN: Tuition Appeal
Committee, 5101 Evergreen Rd., Dearborn, MI 48128
7. Appeal decisions will be emailed to your student HawkMail account within 6 weeks after a
submission has been received and reviewed.
Tuition Appeal decisions will be sent your student HawkMail account.
Registration and Records
Tuition Appeal Form
Student Information
Name: ______________
_____: _______
______ _________ _________ __
________________________
___
_____
__ _______________________________
______ _________ _________________ __
HANK ID Number:
Address
City/State/Zip:
Phone: Email Address: _
Semester you are appealing:
Fall (September – December) Year: ____________
Winter (January – April) Year: ____________
Spring (May – June) Year: ____________
Summer (July – August) Year: ____________
List of Classes Affected
Course Number Section Grade Date Class was Did you Last date of
Dropped attend attendance
class?
(Yes/No)
Registration and Records
Tuition Appeal Form
Which of the following circumstances required you to drop your class(es)?
Student illness during the semester that results in an extended hospitalization
Death of immediate family member during the semester
Military deployment/reactivation during the semester
Certification (all boxes must be checked)
I have read pages one and two of the Tuition Appeal Form and understand the process.
I have attached a typed explanation of the extenuating circumstance.
I have attached the required third party documentation.
I understand that I am only allowed one review for my entire academic history at Henry Ford
Community College regardless of the outcome.
I understand that falsifying information will result in immediate denial and grounds for sanctions
as outlined in the Student Code of Conduct.
I understand that dissatisfaction with a particular teaching style, lack of knowledge of refund
deadlines, and disagreement with refund policies are not grounds for tuition reversal. I understand
that I must drop from the course(s) in question before a tuition reversal will be considered. I also
understand that submission of this form does not guarantee a tuition reversal. I understand that
registration and technology fees are non-refundable.
Signature: ____________________________________
Date: ____________________
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Tuition Appeal Form Registration and Records General Information (Henry Ford College)

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Completed 17 September 2020

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