http://www.emmanuel.edu/Documents/TuitionAid/2010_2011%20Refund%20Request%20Form%20030910

Page 1

Refund Request Form

Student Name: ______________________________________________ SID: _________________________________ Amount Requested: $____________________

Requesting refund for:

(Optional)

Summer 2010 Fall 2010 Spring 2011

Make check payable to: ______________________________________________________________________________ Mailing address:

_______________________________

OR

_____________ __________________

Student Mailbox BOX #: ______________________

_______________________________

Student Signature: ________________________________________

Date: ___________________________

Please note: Refund checks will only be processed after the end of the add/drop period of each semester and after all financial aid funds are received by the college. Refunds checks will be authorized for the amount of the credit balance reflected on your account. A credit balance resulting from financial aid may not occur until all sources of financial assistance have been disbursed to the student account. o For semester based courses, financial aid is disbursed after the add/drop period, however, in some situations, a credit balance may not occur until the end of the semester, particularly if the credit is due in part to state aid. o For accelerated courses, financial aid is disbursed after the add/drop period for the last session of each semester.

SFS Office Use Only:

Notes:

___ All Financial Aid Disbursed

Refund Amount: $_______________

___ Unmet Need Checked

Reviewed By: __________________

___ Spring Balance Covered

Supervisor Signature: ____________

Refund Processed: ___ / ___ / ___

Office of Student Financial Services • 617-735-9938 phone • 617-735-9939 fax • financialservices@emmanuel.edu


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