Request for Refund Appeal

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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:

All refund appeals must be initiated no later than twenty-one (21) calendar days after the class end date. A refund request made after the twenty-one (21) calendar day period will be reviewd at the discretion of the FVTC Registrar, after the class end date.

A student may be responsible for paying back financial aid.

A written personal statement and documentation are required to be considered for a refund appeal.

Classes graded with a letter grade (A-F) are not eligible for an appeal. Students must complete the Academic Appeal process for these classes (www.fvtc.edu/myfvtc/student-policies-forms > POLICIES & PROCEDURES > Academic Appeals).

Student Name*

First Name

Last Name

Student Phone Number*

Student Email Address*

Student ID Number*

Ex: 123456789

DOB*

STEP 1: Class(es) You Are Appealing

Current Program*

How many classes are you appealing?*

(Max of 4)

Class Name*

Class Number

Class Term

Last Date of Attendance*

Class Name*

Class Number

Class Term

Last Date of Attendance*

Class Name*

Class Number

Class Term

Last Date of Attendance*

Class Name*

Class Number

Class Term

Last Date of Attendance*

Did you receive financial aid for the identified term?*

Yes No

Are you requesting a refund for all of your classes?*

Yes No

If no, please explain:*

STEP 2: Reason For Appeal

Please select the reason for your appeal*

Military Orders Medical Student's Children Assault/Domestic Violence Death in Immediate Family Error by FVTC

Other:

You will be asked to provide supporting documentation.

Please upload supporting military documentation

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