Request for Review of Title IV Aid Eligibility Suspension


Personal Information

Student ID (SSN or SID):
Name:
Address:
City / ST / Zip:
Phone:
Email:

I have not met the following standard(s) of academic progress:

I am on academic probation.
I have completed less than 75% of hours attempted.
I am an undergraduate, and I have attempted more than 172 undergraduate hours.
I am a graduate student, and I have attempted more than 45 graduate hours.

During my academic career at UNA I have experienced the following mitigating circumstance(s):

serious illness or accident
serious illness or accident in your immediate family
serious family issues
death in immediate family
other hardship

Brief Description and Date(s):



If you have pertinent supporting documents that you wish to send to the committee, you may email them to this address:sfins@una.edu

If you prefer to bring the documents to the Student Financial Services office, please indicate so here:

I will bring documents to the Student Financial Services Office, in Bibb Graves Hall, Room 226.

If you choose to bring your documents to our office, we will hold your appeal at the front desk for FIVE BUSINESS DAYS to give you time to get the documents to us. If you have not brought or mailed the supporting documents after five business days, we will forward your appeal to the committee without supporting documents.

NOTE: In order to prevent SPAM, we need you to add the number to the number and put the answer here: