PETITION FOR REINSTATEMENT OF FINANCIAL AID
497840901702020-2021 Unusual Enrollment History Form ____________________________________________________________ Student ID #: _____________________________Student Last Name First Name Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review by the Department of Education. Since you received the Federal Pell Grant and/or student loan funds at multiple educational institutions during the 2016-2017, 2017-2018, 2018-2019 and 2019-2020 academic years, Pierce College must review your enrollment history before determining your eligibility for student aid. Your application for financial aid will not be considered until you submitthis completed form and all required documentation. SECTION 1: Schools Attended Please attach a recent unofficial academic transcript from each of the colleges you list below: Name of College Dates Attended (MM/YY to MM/YY) Did You Earn Any Credits? Transcript Attached ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No SECTION 2: Credit earned/Failure to earn credit—Check the ONE box below that applies Option A: I earned academic credit during the specified academic years at all of the institutions listed, as documented by the attached unofficial transcripts. Option B: I failed to earn academic credit at one or more of the institutions listed during the specified academic years. I have attached the following information: A signed statement explaining my failure to earn credit at each applicable institution. Documentation to support my statement/circumstances. SECTION 3: Student signature — please read the statement below before signing All information on this form and in the attached documentation is current and accurate to the best of my knowledge. I understand that my request may be denied if I have not attached all requested transcripts and/or have not adequately explained and documented my circumstances if I failed to complete credits at any the above colleges. ________________________________________________________________________________________Student Signature Date ................
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