Westchester Community College, State University of New York

Tuition Appeal Request Form

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Name *

Student ID# *

Address

Apt, suite, etc.

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Zip code

Phone

WCC Email *

Semester for Tuition Appeal Request

Fall

Spring

Summer

Winter

Year *

Have you attended these classes

Yes

No

Last Date of Attendance *

Do you receive financial aid? *

Yes

No

Date of Consultation with Financial Aid Counselor

Financial Aid Counselors Name

***Please note all appeals must be filed within within 1 year after the end of the term in question to be considered by the Tuition Appeals Committee.

My Tuition Appeal is being submitted on the basis of extenuating circumstances due to: *

Death of the student or of an immediate or very close family member: (parent, child, spouse, domestic partner, sibling or grandparent) Submit a copy of the death certificate, obituary or death notice. Documents must clearly indicate the relationship of the deceased to the student. Illness or Injury of immediate family member for whom you provided care: (parent, child, spouse, domestic partner, sibling or grandparent) A letter from your family member’s medical provider on their letterhead indicating the dates of illness and naming you as the primary caregiver. The letter must be signed by the medical provider. The medical condition does not need to be disclosed to the committee. Copies of invoices, appointment confirmations, statements of insurance payments etc. are not acceptable documentation.

Death of the student or of an immediate or very close family member:

Call to active military duty: A copy of the official deployment/reactivation notice. Deployment and reactivation dates must be within the semester you are appealing.

An accident that prohibited your continued attendance: Accident report must be provided.

Severe family circumstance/hardships: Supporting documentation of hardship must be provided.

Illness or Injury of immediate family member for whom you provided care

Medical Related - please fill out the Medical Appeal Form: All Appeals for medical reasons must be submitted by clicking here:

Personal Statement Summary explaining circumstance checked above.

Additional Documentation – please upload file(s)of any supporting information relevant to your appeal here.

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