2015-2016 Unusual Enrollment History Form
Federal Student Aid Programs
Your 2015-2016 Free Application for Federal Student Aid (FAFSA) has been flagged for “Unusual Enrollment History
Review” by the U.S. Department of Education because you received Federal Pell Grant and/or Federal Loan funds at
multiple education institutions during the review period ‐ 2011-12, 2012-13, 2013‐14, and 2014‐15. This flag requires Calhoun
Community College to review your enrollment history and determine whether or not you are enrolling only long enough to receive
cash refunds of federal student aid. In the process of reviewing your enrollment history, Calhoun Community College will check
the National Student Loan Data System (NSLDS) to obtain a complete history including the name of institutions you have attended
and the dates of attendance. If you have questions, contact us promptly so your financial aid will not be delayed.
Student Information (please print):
_________________________________________________________
_____________________/_________________
________________________
Last Name, First Name, Middle Initial
Social Security# and Student ID (C Number)
Date of Birth
________________________________________________________
_______________________________________________________________________
_________________________________________________________
_______________________________________________________________________
Address
Phone Number (include area code)
City
State
Zip
Email Address
Colleges or Universities attended:
1.
2.
3.
4.
Please list all institutions (including Calhoun) attended during the academic periods that include 2011-12, 2012‐2013,
2013‐2014, and 2014‐2015.
Please attach an official academic transcript for each of the prior schools listed (excluding Calhoun).
Also, for each college listed, attach a typewritten explanation if you failed to earn any academic credit at that college.
Attach any additional documentation (i.e. medical bills, hospitalization records, accident reports, etc.) that supports your
reason for withdrawal. Please make sure to include your Calhoun student number at the top of each page of document
you submit.
Your application for financial aid will not be considered until you submit this completed form and all
required documentation to our office.
Name of College or University
Dates of Attendance
-
Types of aid received (Pell Grant, Loans, etc.)
-
Certification and Signatures
By signing this form, I certify that the information reported and submitted on it is complete and correct.
Purposely giving false or misleading information on this worksheet may lead to fines, jail, or both.
______________________________________________
Student’s Signature
___________________________________
Date
Please note that processing may take 3 – 4 weeks after documents are received especially during peak processing.
MAIL THIS FORM TO ADDRESS BELOW…
Calhoun Community College
Office of Financial Aid
P.O. Box 2216
Decatur, AL 35609
Version 4/8/2015
OR
… return to Financial Aid office located at either campus:
Decatur Campus
6250 Hwy 31 North
Tanner, AL 35671
256-306-2628
Huntsville/Research Park Campus
102-B Wynn Drive
Huntsville, AL 35805
256-306-2628