Tuition Liability Appeal Form

A student who can document that extenuating life circumstances adversely affected his or her ability to pay tuition for a specific semester or term can file a Tuition Liability Appeal with the office of the Bursar. Please review the application below and submit the required documentation for your request to be reviewed.

Your Name(Required)

First Last

Email(Required)

Student EMPL ID:(Required)

Semester and Session in Dispute:(Required)

Your Address(Required)

Street Address Apt # City State ZIP Code

Your Phone(Required)

Alternate Phone(Required)

Below, in 350 words or less, please explain the basis of your appeal. Please ATTACH copies of all supporting documentation, statements, or letters before submitting appeal form.(Required)

Upload File

Max. file size: 5 MB.

You must upload any supporting documentation you may have to support your claim. (eg: employment separation, rent bill…etc.). Click the upload button to attach files via Dropbox (A new window will open). After submitting your files, please continue completing this form.

Disclaimer and Signature

By signing below, I certify that the above, and any information written, or documents submitted is both accurate and true to the best of my knowledge. I have read the Tuition Liability Appeal Guidelines as well as the University tuition Refund/liability and fees policies and am still eligible to file for a Tuition Liability Appeal. I understand that this form is for students who are disputing tuition charges ONLY and the decision of the Tuition Liability Appeal Committee is FINAL and not subject to appeal.

Name:

Date

Phone

This field is for validation purposes and should be left unchanged.