Special Circumstance Review Request Form

Student Name*

First NameLast Name

Mid Michigan College Student ID Number*

You can find your Student ID Number on your Mid Michigan College Student ID Card or in myMid.

Enter Your Mid Mich Email*

example@midmich.edu

Phone Number*

Area CodePhone Number

Have you completed the 2024-2025 FAFSA?

YesI'm not sureNo

Select the year or years you would like us to review.*

2025-20262026-2027

Are you eligible for the full Pell Grant amount?

YesI'm not sureNo

My financial situation was adversely impacted by the COVID-19 pandemic.

YesNo

Provide a detailed explanation as to why your current financial situation does not match what is being reported on the FAFSA. Some situations that may qualify include job loss, significant reduction of income, or separation/divorce of parents. *

I have documentation to support my current financial situation as it compares to the financial information provided on my 2023-2024 FAFSA.

YesNo

Signature*

Today's Date*

MonthDayYear

Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact Strategic Communications at (989) 386-6622 x579 or stratcomm@midmich.edu.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.