Fitchburg State University

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  This form should be used by students with extenuating circumstances that prevented the student from attending class or enrolling at the university such as:

• Significant illness or injury
• Significant illness or death of an immediate family member
• Military deployment/call to active duty
• Enrollment/attendance at another college/university while never attending class at
Fitchburg State University

In all cases, verification from sources other than the student is required (completed health care provider verification form or letter from health care professional on letterhead, copy of death certificate or obituary, copy of military orders, verification of class non-attendance from faculty, etc.)

Circumstances Not Sufficient to Support a Tuition Refund Appeal Include, But Are Not Limited to:

• Not being aware of add/drop deadlines or forgetting you were registered.
• Lack of familiarity with student information systems.
• Insufficient financial aid and/or financial hardship.
• Dropping courses to avoid low grades.
• Deciding that school/work/life responsibilities are too overwhelming.
• Arrest/Incarceration.
• Academic or Disciplinary Dismissal.
• Dissatisfaction with instructor or course content or determining that courses you took
do not meet your academic and/or personal goals.
• Advising, or other academic department processing issues, are not considered a
university error.

  My signature below affirms that I understand the following:

1. Students are responsible for ensuring all supporting documentation is submitted with the initial appeal package. Incomplete appeal packages will not be reviewed until all supporting documentation has been received which might result in a delay of the final decision.

2. Adjustments to withdrawal dates and tuition & fee charges may impact financial aid eligibility, which may result in the need for students to return any financial aid that has already been refunded to them.

3. Committee meetings are held once each month. Appeals are heard in the order received and must be received no later than the last day of the month in order to be heard in the next month.

4. Submission of this package does not guarantee that your appeal will be granted.

By typing in my full name I am signing this document