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:
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Student’s SSN: |
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EmplID: |
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Last Name |
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First Name |
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MI |
Jr.,3rd |
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Indicate the term for which you are requesting a refund/drop (i.e., Summer 1998, etc.) |
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Are you requesting a refund/drop for all of your classes? |
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Yes |
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No |
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If no, indicate how many credit hours will be left after the refund/drop |
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,then list the class(es) for which you are |
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requesting a refund: |
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Class and Title |
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Class and Title |
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Class and Title |
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Class and Title |
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Please check the reason for request: |
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Major Medical Emergency |
Administrative Error |
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Extreme Financial Hardship |
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SIGNATURE OF STUDENT: |
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DATE: |
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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: