SOM Financial Aid Inquiry

SOM Financial Assistance Request
Use this form to request assistance with any financial aid, student refund (disbursement), billing, health insurance, and/or scholarship concern/issue.
Date form was submitted*

MonthDayYear
Date
Name*

First NameLast Name
UIW Identification Number*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
UIW Email Address*

Confirmation Email
DOMBS
TuitionQuestions about your BillFinancial AidScholarship

SOM Financial Assistance Request