2024-2025 Unusual Circumstances Appeal Request Form

Contact Information

First Name

Last Name

Preferred Email

Date of Birth

Home or Cellphone

We have received your 2024 - 2025 FAFSA. You indicated that you have unusual circumstances which make you an independent student. Unusual circumstances include, but are not limited to:

Human Trafficking, as described in the Trafficking Victims Protection Act of 2000 (22 U.S.C. 7101 et seq);
Legally granted refugee or asylum status;
Parental abandonment or estrangement;
Student or parental incarceration.

Please indicate your unusual circumstances.

Human traffickingLegally granted refugee or asylum statusParental abandonment or estrangementStudent or parental incarcerationMy parent(s) refuse to complete the FAFSAMy parent(s) do not and will not provide any financial support to me.I do not have unusual circumstances. I will correct my FAFSA to include my parental information.Other

Please submit a typed letter of explanation detailing the unusual circumstances that make you independent from both parents. If you are unable to upload the letter, please submit it to the Financial Aid office through Net Partner.

Address the following in your explanation:

The nature of your relationship with both of your parents
Provide the date and place of your last contact with both parents
How you have been supporting yourself

Submit any supporting documentation for your unusual circumstances. Supporting documentation may include, but is not limited to, the following:

A court order or official federal or state documentation that you or your parent(s) or legal guardian(s) are incarcerated;
A written statement from:

a state, county, or tribal welfare agency;
An independent living case worker who supports current and former foster youth;
A public or private agency, facility, or program servicing the victims or abuse, neglect, assault, or violence

Please submit a signed and dated statement from your parent(s) confirming that they either:

Refuse to complete the FAFSA or
Do not and will not provide any financial support to you including the date the financial support ended.

If your parent(s) refuse to sign and date a statement to this effect, please submit documentation from a teacher, counselor, cleric, or court confirming your situation.

Edit this text

	Yes	No
Did either of your parents claim you as an exemption on their federal tax return in 2023?
Will either of your parents claim you as an exemption on their federal tax return in 2024?
Did either of your parents provide your health insurance in 2023?
Will either of your parents provide your health insurance in 2024?
Did either of your parents provide your auto insurance in 2023?
Will either of your parents provide your auto insurance in 2024?

	Monthly Amount
Income from work	$
Unemployment Compensation	$
Social Security Benefits	$
Housing Assistance	$
Food Stamps	$
Other Income (monetary gifts)	$
Total	$

2024-2025 Unusual Circumstances Appeal Request Form

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