Panola Promise Program—Request for Reconsideration for Extraordinary Circumstances

YOU MAY ONLY SUBMIT A REQUEST FOR RECONSIDERATION ONCE DURING YOUR ENTIRE TIME IN THE PANOLA COLLEGE PROMISE PROGRAM
Request for Reconsideration for Extraordinary Circumstances

PANOLA COLLEGE PROMISE PROGRAM
The Panola Promise Program offers the opportunity to request reconsideration of eligibility determinations in the event of extraordinary circumstances. An extraordinary circumstance is defined as a significant event that was unforeseen and completely out of the family's control. Examples of extraordinary circumstances may include, but are not limited to, death in the family, accident, or sudden extended illness.

Required Documentation
- This completed form.
- Verifiable supporting documentation (where applicable For example: For example, a request for failing to meet GPA requirements might include a current transcript and a detailed plan on how you intend to bring your GPA back up to the required 2.0 GPA.
Forms will only be accepted using this online form

Deadline to submit forms is as follows:

High School Students: August 1st each school year

College Students: August 1st to attend the Fall Semester

January 1st to attend the Spring Semester

May 20th to attend a summer session

Incomplete or late forms WILL NOT be reviewed.
Name*

First NameMiddle NameLast Name
Phone Number*
Email Address of Student:*
example@example.com
Please check which type of student you are:

High School StudentCollege Student
Name of High School*
High School Student ID:*
Panola College Student ID:*
The eligibility requirement(s) you are requesting reconsideration for:*

Ex: I failed to maintain a GPA of 2.0 or better or I failed to complete my 25 hours of volunteer service work by May 15th. 0/40
Written Statement: Please use the space below to provide your written statement. This is your opportunity to explain your particular situation and detail why you need a reconsideration. Include any relevant details that would help the committee understand the circumstances surrounding your request. *

Maximum 250-word response.0/250
Please read the statements below and acknowledge understanding:
- I verify that all information and documents provided are true and accurate.
- I understand that this is a written process; no in-person requests will be permitted.
- I understand if this request is approved, the Panola Promise Program eligibility will be reinstated during the fall semester.
- I understand that Panola Promise Program requirements must continue to be met during the request for reconsideration process in order to have eligibility reinstated.
Please upload all required supporting documentation here.*

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Student Signature*

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