Refund Exception Appeal Request

General Information

Appeal requests must be submitted by the student and documentation is required. If approved, adjustments to the refund percentage are based on the documented date of the extenuating circumstance and the refund percentage in place during the documented time. A change in assessment can only be adjusted or prorated to a refund percentage rate already established in the published University tuition and required fees schedule (100%, 75%, 50%, or 25%).

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Student Information

Full Name (First & Last Required)

BearPass (M#)

Date of Birth (mm/dd/yy)

Phone number (xxx-xxx-xxxx)

Questions

Reason for Appeal Exception:(Required) This field is required.

What is your email address? This will be used to send communication from the committee, including the committee's decision.(Required) This field is required.

What semester are you appealing?(Required) This field is required.

Year(Required) This field is required.

Please list all classes for which you are requesting a refund. (ex. MTH 135, ENG 110) Classes must have been dropped with a "W" grade to be eligible for an appeal.(Required) This field is required.

List the date you last academically participated in each course(s) for which you are appealing: (ex. ENG 111 - last day I participated was 9/30/2023).(Required) This field is required.

Why do you believe a refund should be granted? Describe the extenuating circumstances involved, including specific relevant dates. Please be brief & send timeline of incident(s). Refunds are granted based on the date of incident and University refund & drop deadline percentages. Please include the steps you took during the semester and how the events impacted your education.(Required) This field is required.

If this is a classroom concern, did you speak to the instructor and/or Department Head about this issue?(Required)

No Yes Not applicable

You must make at least one selection.

Did you receive Federal Financial Aid or Veteran benefits?(Required)

No Yes

You must make at least one selection.

Documentation is required for a successful appeal, including non-attendance. It should be uploaded below at the time of appeal and not submitted separately. The appeal will be denied if documentation is not included.(Required)

I understand.

You must make at least one selection.

Supporting Documentation

Upload all documentation supporting your case. Examples may include but are not limited to: • Letter from physician, copy of statements, written verification including dates of medical circumstances • Copy of obituary or funeral program • Emails from instructors verifying non-attendance 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

General Information

Student Information

Questions

Supporting Documentation

Submission