Rescind Student Permission Request Form

If you no longer wish to have your Title IV financial aid automatically pay "non-allowable" tuition account charges, complete the form below and click the button to send it to the Bursar's Office to rescind your FA_ALL Student Permission.

  • This rescind action is not retroactive; any “non-allowable” charges paid with Title IV financial aid prior to this request cannot be changed.
  • After the rescind action, financial aid will not pay any “non-allowable” charge. If you have a “non-allowable” charge and financial aid, you will receive a refund for unapplied financial aid and a bill for the unpaid charge. A late fee may apply and a hold placed on your account to prevent future enrollment if payment is not received by the due date.
  • You may select to use the Student Permission option again at any time.

All fields in this form are required.

Last Name               First Name           Middle Initial


 Click this check box to indicate your wish to RESCIND your FA_ALL Student Permission.

Before clicking the "submit" button, print a copy of this page for your records.