2022-2023 LOAN CHANGE REQUEST

2022-2023 Loan Change Request

This form is to change an existing Federal Direct loan only. You may request up to two changes per academic year. Changes may take up to 2 weeks to process.
Student Name: *

First Name Middle Name Last Name
Student ID Number: *
Email *
example@example.com
Phone Number *

Area Code Phone Number
Major: *
Anticipated Graduation Date: *

Month Day Year
Date
Check the box that best applies to you and fill in any necessary blanks:
Please cancel my loans for:

Fall Spring Summer
If your loan for the semester(s) specified has disbursed and you have received a refund, you must return the refund amount to our office before the cancellation can be processed.
Cancellation of Pending Disbursements:

I would like all PENDING DISBURSEMENTS cancelled
Specify the reason for cancellation of PENDING DISBURSEMENTS:

I am attending another college. I am receiving additional financial aid
Loan Decrease:

I would like to REDUCE my loan (If selected, please complete the fields below).

Please REDUCE my existing loan to $ (enter amount) for the indicated semester(s): *

Your decrease will only be evaluated based on the semester(s) you fill out.
Loan Increase:

I would like to INCREASE my loan (If selected, please complete the fields below).

Please INCREASE my existing loan to $ (enter amount) for the indicated semester(s): *

Your increase will only be evaluated based on the semester(s) you fill out.
Please summarize your loan change request here: *
Certification Statement: *

I understand that: it may take two (2) weeks for my loan change to be processed; I can only submit two (2) loan changes each academic year; I must be enrolled and actively attending six (6) credit hours to qualify for disbursement of my loan; my requested loan amount may be adjusted based on my cost of attendance , estimated financial aid, and graduation date.
Signature *

Clear
Date *

Month Day Year
Date
As set forth in its student catalog, West Georgia Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, sex, age, religion, disability, political affiliation or belief, genetic information, disabled veteran, a veteran of the Vietnam Era, or citizenship status (except in those special circumstances permitted or mandated by law). The following persons have been designated to handle inquiries regarding the non-discrimination policies: Equity (Title IX) Coordinator, Dean of Students, 770.537.5722, 176 Murphy Campus Blvd., Waco, GA 30182. ADA (Section 504) coordinator is V.P. of Administrative Services, 678.664.0533, 401 Adamson Square, Carrollton, GA 30117.
Should be Empty:

2022-2023 Loan Change Request