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Valencia Community College Federal Financial Aid Authorization Rescission of Authorization

Please make your selection carefully; this will affect your ability to purchase items in the Valencia Bookstore. Should you select to rescind your Title IV Authorization and there is a balance from the Bookstore on your account you will still be held responsible for this debt. Make your selection(s) on the form below and submit it in person to the Business Office on any campus. Campus Locations: East Campus 701 N. Econlockhatchee Trail, Orlando, FL 32825 407-582-2225 Osceola Campus 1800 Denn John Lane, Kissimmee, FL 34744 321-697-4130 West Campus 1800 S. Kirkman Road, Orlando, FL 32811 407-582-1200 Winter Park Campus 850 W. Morse Blvd., Winter Park, FL 32789 407-582-6055

If you later change your mind ad would choose to participate, log into your ATLAS Account and follow these instructions: Click on the Students tab Click on Federal Student Aid Payment Authorization in the Financial Aid Reminders Channel


Valencia Community College Federal Financial Aid Authorization Rescission of Authorization

With the submission of this form, I am rescinding my authorization for Valencia to use my Federal Financial Aid to pay for non – institutional charges, such as Valencia bookstore purchases, parking fines, etc.

With the submission of this form, I am rescinding my authorization for Valencia to use my Federal Financial Aid to pay for prior year non – institutional charges, such as Valencia bookstore purchases, parking fines, etc.

With the submission of this form, I am rescinding my authorization for Valencia to use my Federal PLUS Loan proceeds to pay for non – institutional charges, such as Valencia bookstore purchases, parking fines, etc. NOTE: Please check all of the appropriate boxes above

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Print Name

VID#

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Signature

Effective Date


/TIV_Rescission