Unusual Enrollment
History Appeal Form
Northwest State Community College • 22600 State Route 34 • Archbold • OH • 43502
Phone: 419-267-1333 • Fax 419-267-5587 • finaid@northweststate.edu
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Name: ___________________________________ NSCC ID number: N________________________
Phone: _________________________ Email: _____________________@students.northweststate.edu
Which term will you be attending next? (check one): __ Summer 2020 __ Fall 2020 __ Spring 2021
Current major: ______________________________________________________________________
U.S. Department of Education Unusual Enrollment History Regulation (GEN-13-09)
Academic Credit Not Earned – if the student did not earn academic credit at a previously attended institution and, if
applicable, at the institution performing the review, the intuition must obtain documentation from the student
explaining why the student failed to earn academic credit. The institution must determine whether the documentation
supports (1) the reasons given by the student for the student’s failure to earn academic credit; and (2) that the student
did not enroll only to receive credit balance funds.
Reasons could include illness, family emergency, change in students living arrangement, and military obligations. The
institution should, to the extent possible, obtain third party documentation to support the student’s claim. The
financial aid administrator may choose to require the student to establish an academic plan, similar to the type of plan
used to resolve satisfactory academic progress appeals.
If the student did not earn academic credit at one or more of the relevant institutions and does not provide acceptable
explanation and documentation for each of those failures, the institution must deny the student any additional title IV
program assistance.
If the institution denies a student continued title IV program assistance, it must provide the student with information
as to how the student may subsequently regain title IV program eligibility. Since the basis for the denial is the
student’s academic performance, it is expected that successful completion of academic credit would form the basis for
the student’s subsequent request for renewal of title IV eligibility. This could include meeting the requirements of an
academic plan that the institution established with the student.
Dates of Attendance
(To – From)
(MM-DD-YYYY)
Transcript
Received by NSCC
*We will not be able to process your file until we receive transcripts from each of the listed institutions.
The information provided on this form, in my typed statement and all accompanying documentation, is accurate
and complete to the best of my knowledge. I agree to provide additional documentation if requested by the
Financial Aid Office.
Student Signature: _______________________________________ Date: ________________________
Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion
or age in its programs or activities.
