USHE Scholarship Appeal Form

USHE Scholarship Appeal Form

This form is for students who applied for a state scholarship through USHE and received an adverse decision they wish to appeal.
Utah Board of Higher Education policy for state aid programs administered by USHE states that applicants have the right to appeal an adverse decision regarding their scholarship application. The requirements for each program are unique and vary, so please review the requirements of the programs here before proceeding.

Appeals must be submitted within 30 days of the date the denial notification is sent to the student. The appeal must provide evidence that the adverse decision was made in error and that, in fact, you met all scholarship requirements and submitted all requested documentation by the deadline. Appeals filed in an attempt to change the scholarship requirements are beyond the scope and purpose of the appeals process.

As the student applicant, it is your responsibility to file the appeal, including all supplementary documentation. To complete this appeal form, you will need to provide a typed statement explaining why you're appealing and any supporting documentation you wish to be considered.

It is estimated that notice of a decision regarding your appeal will be sent to the student via the email included below 4-6 weeks after receipt of all appeal application documents.

Submission of an appeal does not guarantee reversal of the original decision.

Demographic Information

It is very important that the information you provide below is accurate so we can identify your original application and contact you with updates or requests going forward.
Name*

First NameLast Name
Preferred Name
Scholarship program you are submitting an appeal for:*
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
High school you last attended*
Please type the name of your Utah high school
Year you graduated high school*
If you are currently enrolled in college, list the college you are attending
Please select your enrollment plans for the Fall 2024 semester*
Semester your deferment will end*
Year your deferment will end*
Please select the institution you plan to attend.*
Please select the institution you plan to attend. *
Would you like to create a PIN to grant permission for a specified person to access and receive specific information about the scholarship application and appeal? (Please note, if you have already completed this process, you do not need to do so again. Select no to skip to the next part of the appeal form).*

YesNo

Student Information Release Form
Student information is governed by the federal Family Educational Rights and Privacy Act (FERPA). This law extends privacy rights to students, age 18 and over, regarding their educational records and information. You are not required to give permission to anyone to access your confidential education records (e.g., grades, financial information, etc). However, by listing them below, you may give permission for specified person(s) to use your personal identification number (PIN) to access your education records related to the {scholarshipProgram}. Only you or a person on the list may access your records with the PIN.

You should keep your PIN private and not share it with anyone except those listed below. If you ever want to change your pin and who has access, you may contact the scholarship office via email (scholarships@ushe.edu) to request an update.

I, the undersigned, grant permission for the person(s) listed below to access my education records related to the {scholarshipProgram} if they provide my PIN number to scholarship staff. I understand that this permission only allows the person(s) listed below to access information, not to make changes to my account.
Student Signature (please type full legal name)*
Date

MonthDayYear
PIN (5 digits, numbers only)*
Name of Person(s) to be given Permission of Release
Full Name*

First NameLast Name
Relationship to Student*
Phone Number*
Please enter a valid phone number.
Would you like to add a second person?*

YesNo
Full Name*

First NameLast Name
Relationship to Student*
Phone Number*
Please enter a valid phone number.

Appeal Information
This appeal is related to (mark all that apply):*

Academic RequirementsDocumentationApplication ErrorFAFSA CompletionOther
This appeal is being filed:*

within 30 days of the date of the denial letterafter the 30-day appeal window listed in the denial letter. (Per board rule, students must provide an additional statement for the appeal committee regarding the circumstances that caused the late appeal. If you check this box you must attach a separate late statement below).
You must submit a statement, written by you (the scholarship applicant), detailing why you are appealing and include information to support your claims. (Providing specific dates and/ or a timeline(s) can be helpful for the committee.) Please include all information you would like the committee to consider.*

Please upload your statement(s) here. Generally, statements should be no longer than 1 page, 12 point font. If you are appealing after the 30-day window, you must specifically address the reasons that led to the late filing of your appeal.
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You have one opportunity to appeal; therefore, including all supporting documentation you want the committee to consider is vital. For example, if your transcript had an error on it, please include a new transcript showing that the error has been corrected. Failure to include supporting documentation could impact the outcome of the appeal.
When including supporting documents, please list the type of document(s) and then upload them below (or indicate how they are being submitted if they are being sent separately via parchment or your high school):*
Upload supporting documents here*

You may submit more than one document.
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I understand and agree to the appeal application rules outlined in this form.

I understand that the scholarship team may contact me on behalf of the appeal committee to request additional information using the contact information provided.

I understand that once a decision is made, I will be notified via email using the email address provided on this form.

I certify that all information provided for this appeal application is true and accurate.
Applicant Signature*
Should be Empty:

USHE Scholarship Appeal Form

Demographic Information

Student Information Release Form

Name of Person(s) to be given Permission of Release

Appeal Information