Rev. 2/15/2019 1 EHHLD
Unusual Enrollment History Appeal – 2019-2020
Name: ACC Student ID:
Your 201920 Free Application for Federal Student Aid (FAFSA) has been flagged forUnusual Enrollment History Review” by the U.S.
Department of Education because you received Federal Pell Grant or Direct Loan funds at multiple education institutions during the review
period 2015‐16, 2016‐17, 2017‐18 and 2018-19. This flag requires Arapahoe Community College to review your enrollment history and
determine whether or not you are enrolling only long enough to receive cash refunds of federal student aid. In the process of reviewing your
enrollment history, ACC will check the National Student Loan Data System (NSLDS) to obtain a complete history including the name of the
institutions you have attended and the dates of attendance. If you have questions, contact us promptly so your financial aid will not be delayed.
Your application for financial aid will not be considered until you submit this completed form and all required documentation to our office.
Schools Attended
1. List all colleges attended during the time frame listed below. If you attended multiple schools during the indicated time frame,
attach an additional page listing all schools you attended.
2. Provide an official academic transcript for each of the prior schools listed. (This must be sent in a sealed envelope directly from the
college you attended to the Financial Aid Office at ACC or you must bring in the sealed envelope once the school sends it to you.)
3. You must attach a written explanation for each school explaining your Unusual Enrollment History.
Dates Attended
Name of College
Did you earn credits?
Explanation of Extenuating Circumstances
You must offer reasons to explain your Unusual Enrollment History. You must attach third party documentation (see acceptable categories
found below) to corroborate your claim or you will be denied Financial Aid. Please select one of the boxes below and provide the required
Medical documentation of sickness or hospitalization of self, child or parent. We encourage you to set up an
appointment with Student Life. They will review your medical documentation and issue a Medical or Disability
Verification Form. Include this verification form with your Unusual Enrollment Appeal as supporting documentation.
Military withdrawal (include documentation from commanding officer)
Victim of a crime or unexpected disaster (include a copy of police report, third party letters, etc.)
Other circumstances not addressed in the above categories. Submit a written statement that explains your situation
including supporting documentation.
By signing this document, I certify that the information is complete, true and accurate. I understand that purposely providing false or
misleading information could result in criminal prosecution, prison sentence, and/or a fine pursuant to U.S. Criminal Code and Colorado
Criminal Code.
t Signature Date
Arapahoe Community College Office of Financial Aid • 5900 S. Santa Fe Drive Littleton, CO 80120
Phone: 303.797.5661 • Fax: 303.797.5663 • Email: