Fillable University Hawaii Hilo Academic Bankruptcy Declaration Form

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University Hawaii Hilo Academic Bankruptcy Declaration Form

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Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm SSB E-101
/ Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
To process: Submit original to the Office of the Registrar, copy to student, student’s advisor, student’s file
Academic Bankruptcy Declaration Form
Information for the Student:
I have taken note of all courses required for graduation affected by this declaration. I understand that I may need to retake courses
or otherwise fulfill requirements previously fulfilled by courses now declared bankrupt.
UNDER NO CIRCUMSTANCES MAY LESS THAN A FULL SEMESTER’S WORK BE DECLARED BANKRUPT.
I understand that the following conditions apply:
1. The GPA will be recalculated to exclude ALL of the grades from the bankrupt semester. HOWEVER, the grades from that semester
will remain on the transcript.
2. Students may not enroll in a course and receive a grade INCLUDING “W” more than three times unless the course is identified as
repeatable. A course declared bankrupt will count as one of the three attempts.
3. Bankruptcy must be declared PRIOR to graduation.
4. Only one semester may be declared bankrupt during a student’s academic career at UH Hilo.
5. Once declared, academic bankruptcy is NOT revocable.
6. A signature of a Financial Aid Counselor is required so that the students understand the financial aid implications of declaring
bankruptcy. (The signature is required even if the student never received financial aid).
7. Students receiving assistance from other agencies, such as the Veterans Administration, are responsible for determining if there will
be consequences for declaring academic bankruptcy.
Revised 7/17/14
Student Information:
Student Name: Student ID#:
Email Address: @hawaii.edu Phone:
Address:
I declare (Semester) (Year) to be an academically bankrupt semester.
Signatures:
1. Date:
2. Date:
3. Date:
4. Date:
Student
Academic Advisor
Financial Aid Office Counselor
UH Hilo Dean or Assistant Dean of the College
Street or PO Box
City
Zipcode
State
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University Hawaii Hilo Academic Bankruptcy Declaration Form

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Completed 6 February 2020

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