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Request for Refund Appeal

Important Information:

  • All information submitted is strictly confidential.
  • Submitting an appeal with documentation does not guarantee a refund, reduced tuition and fees, or removal of assessed collection fees.
  • Financial aid awarded for the requested term will be subject to the published policies.
  • Submitting an appeal does not exempt the student from any financial hold or collection costs.

FVTC will consider appeals in extenuating circumstances (situations outside of the student’s control) and decisions will be made at FVTC’s discretion.


Please check the box to acknowledge you understand the following:

Student Name*
Ex: 123456789
DOB*

STEP 1: Class(es) You Are Appealing

(Max of 4)
Did you receive financial aid for the identified term?*
Are you requesting a refund for all of your classes?*

STEP 2: Reason For Appeal

Please select the reason for your appeal*
You will be asked to provide supporting documentation.
No File Chosen
File uploads may not work on some mobile devices.
Example: Copy of your orders
No File Chosen
File uploads may not work on some mobile devices.
Should state the nature of your illness/injury, the date(s) of the occurrence, and that you are able to return to school
No File Chosen
File uploads may not work on some mobile devices.
Examples: Record of doctor visits, hospitalization records, letter from child's doctor
No File Chosen
File uploads may not work on some mobile devices.
Examples: Police report, court documentation, letter from clergy, social worker, counselor or doctor
No File Chosen
File uploads may not work on some mobile devices.
Examples: Obituary, funeral program, copy of Death Certificate | Should include date and indicate relationship to the deceased
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

STEP 3: Personal Statement

STEP 4: Review & Sign

Policies:

Use your mouse or finger to draw your signature above
Date

Refund Appeal Committee

Status*
Is student a veteran?*
Is Financial Aid Present?*
F Grade Present:
Previous Refunds?
Previous Refund Date:*
Processed By*
Date/Time*