Jsrcc Form 11 0009 PDF Details

Navigating the complexities of tuition refunds or course withdrawals at educational establishments often involves understanding specific procedures and paperwork, like the J. Sargeant Reynolds Community College's Jsrcc 11 0009 form. This particular form serves as a crucial tool for students requiring to request a refund of credit hours or to drop courses late under certain stringent conditions outlined by the college's policy (College Policy 1-2). The policy delineates that eligible circumstances for refunds or late drops include major medical emergencies impacting the student or their immediate family, the death of a student or their immediate family member during the initial phase of a course, errors made by the college's administration, or cases of extreme financial hardship occurring at the course's outset. The form mandates detailed personal and course-related information, along with a need for pertinent documentation to substantiate the claim, like a physician's note for medical emergencies or proof of a family member's death. Financial aid recipients are cautioned regarding claims of financial hardship, which require additional verification. The form's structured process, involving multiple checkpoints and officials' signatures, underscores the institution's commitment to due diligence while providing a potential financial reprieve for students facing unprecedented struggles.

QuestionAnswer
Form NameJsrcc Form 11 0009
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesreynolds refund, EmplID, disapproval, j sargeant reynolds financial aid refund

Form Preview Example

J. SARGEANT REYNOLDS COMMUNITY COLLEGE

Tuition Refund/Late Drop Request Routing Slip

Policy Section: (College Policy 1-2)

Students are eligible for a refund of those credit hours dropped during the published drop period. After the published drop period has passed, there shall be no refunds, except under the following conditions:

Major Medical Emergency:

Student or member of student’s immediate family is hospitalized or under a physician’s care with specific orders to remain at home. The request must be accompanied by a physician’s letter indicating that the student or member of the student’s immediate family was incapacitated during the first 25% of the length of the Class or the first four weeks of the semester. The physician’s note must include specific dates for the period of inca- pacity.

Death of student or member of immediate family during the first 25% of the length of the Class or the first four weeks of the semester; copy of the official death notice must accompany request. A published newspaper obituary may serve as an official death notice.

In no case will a tuition refund be granted for a major medical emergency more than one semester beyond the end of the se- mester or term.

Administrative Error:

Administrative error made by the college. This must be supported by documented information.

Extreme Financial Hardship:

Demonstrated financial hardship that occurred during the first 25% of the length of the class or the first four weeks of the semester and based upon documentation presented.

In no case will a tuition refund be granted for extreme financial hardship more than one semester beyond the end of the semester or term.

Student’s Section - To Request a Tuition Refund/Late Drop, Please Complete the Following:

 

Student’s SSN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EmplID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

MI

Jr.,3rd

 

Indicate the term for which you are requesting a refund/drop (i.e., Summer 1998, etc.)

 

 

 

 

 

 

 

 

 

Are you requesting a refund/drop for all of your classes?

 

 

 

 

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

If no, indicate how many credit hours will be left after the refund/drop

 

 

,then list the class(es) for which you are

 

requesting a refund:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class and Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class and Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class and Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class and Title

 

 

 

 

 

 

 

 

Please check the reason for request:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Major Medical Emergency

Administrative Error

 

 

 

Extreme Financial Hardship

 

 

 

 

 

 

 

 

SIGNATURE OF STUDENT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please attach the required documentation mentioned in the above policy. Failure to attach the documentation or incomplete documentation will result in your request being denied.

(Please Note: If financial aid funds were used to pay your tuition, you will not be able to document an extreme financial hardship.)

Please attach a completed “ADD/DROP Form” (JSRCC Form No. 11-0002).

If you have an address and/or telephone number that is different than what is on file in your college records, please complete and attached a “Student Request to Update Information Form” (JSRCC Form No. 11-0007).

Forward this form, your completed ADD/DROP form and the required documentation to the campus Success Center:

JSRCC Form No. 11-0009 Page 1 of 2: Tuition Refund/Late Drop Request Routing slip form 02/08

Tuition Refund/Late Drop Request Routing Slip

Student’s SSN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EmplID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

MI

Jr.,3rd

 

 

 

 

Financial Aid Officer’s Section (to be completed for each student request):

 

 

 

 

 

 

 

Did this student receive financial aid for the term he/she is requesting a tuition refund/late drop?

Yes

No

 

 

 

 

If this student received financial aid, will he/she owe a repayment to financial aid programs?

Yes

No

 

 

If the student will owe a repayment, indicate the program(s) and amount(s):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Success Center Coordinator

 

 

 

 

 

 

 

I recommend approval

 

I recommend disapproval

 

 

 

 

 

 

 

Comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE:DATE:

 

Associate Vice President of Academic Affairs or Designee

I recommend approval

I recommend disapproval

Comments:

 

 

 

 

 

SIGNATURE:DATE:

Business Office Section

Has the student completely repaid the amount(s) listed above?

Yes

No

 

SIGNATURE:

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Processing Section

 

 

 

 

 

 

 

Central Admissions & Records Office:

 

 

 

 

 

 

 

 

Late drop process completed by:

 

 

 

DATE:

 

Central Business Office:

 

 

 

 

 

 

 

 

 

Student’s account records updated by:

 

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

Refund request submitted by:

 

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

JSRCC Form No. 11-0009 — Page 2 of 2 02/08

How to Edit Jsrcc Form 11 0009 Online for Free

Our PDF editor makes it easy to complete the REYNOLDS document. You will be able to make the document easily through these simple actions.

Step 1: Choose the orange button "Get Form Here" on the following web page.

Step 2: At the moment you're on the file editing page. You may change and add content to the document, highlight words and phrases, cross or check selected words, insert images, put a signature on it, get rid of unnecessary areas, or remove them completely.

The following areas are what you will have to prepare to get the prepared PDF document.

stage 1 to filling in repayment

Within the box Students SSN, EmplID, Last Name, First Name, MI Jrrd, Financial Aid Officers Section to, Did this student receive financial, If this student received financial, SIGNATURE, DATE, Success Center Coordinator, I recommend approval cid, I recommend disapproval cid, and Comments enter the particulars which the application asks you to do.

Filling in repayment step 2

It is crucial to provide some information inside the area SIGNATURE, DATE, Associate Vice President of, I recommend approval cid, I recommend disapproval cid, Comments, SIGNATURE, Business Office Section Has the, cid No, DATE, DATE, SIGNATURE, Central Admissions Records Office, and Processing Section.

Finishing repayment stage 3

The Central Business Office, Students account records updated by, Refund request submitted by, JSRCC Form No Page of, DATE, and DATE section is the place where both sides can indicate their rights and responsibilities.

Filling out repayment part 4

Step 3: Select the button "Done". The PDF file is available to be exported. You may upload it to your computer or email it.

Step 4: Create duplicates of your file - it can help you prevent forthcoming worries. And fear not - we are not meant to share or view your data.

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