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Appeal for Refund

Student Number:
("700" Number)
 
Your UCM e-mail address:  
Name:  
Semester for which credit is being requested:  
Year:  
Street:  
City:  
State:  
Zip:  
Phone Number:  
I am a graduate student:   Yes
My Major:  

Please enter the information for the course(s) you are requesting refund for: **Note. You cannot use this form to completely withdraw from the university. To withdraw from the university please contact the Student Experience and Engagement.

You must have dropped a course before you can request a refund.
Prefix Number Section Online?

If you added a course or courses to replace the dropped course(s), then please list:
Do you receive Financial Aid?:   Yes    No
Do you receive Voc-Rehab monies?:   Yes    No
Please explain the reason for your credit request:  

Important: You may need to provide all relevant documentation from the instructor, doctor, military orders, etc. that includes your name, relevant dates, attendance status and the like to support the refund request. We will contact you via your MuleMail e-mail account for these documents if they are needed.
Before submitting this form please read the university fee refund policy.

By submitting this form I attest that I have read the refund and financial aid policies mentioned above.