Backdated Drop/Refund Exception Request

1
Name* This field is required.
First Name
Last Name
2
Mid Michigan College Student ID* This field is required.
You can find your Student ID Number on your Mid Michigan College Student ID Card or in myMid.
3
Phone Number* This field is required.
Area Code
Phone Number
4
Email* This field is required.
example@example.com
5
Have you met with your Mid Mentor prior to submitting this request?* This field is required.
Yes
No
6
Have you met with Financial Aid prior to submitting this request?* This field is required.
Yes
No
7
Select one of the categories below to best describe the reason for your request. This field is required. Be sure to scroll to see all available options. You will be asked to upload supporting documentation on a later question.* This field is required.
US Military deployment
Death of an immediate family member
Death of the student
Verifiable, significant medical situation incapacitating the student from returning that semester
Verifiable error on the part of Mid Michigan College
Extraordinary event prohibiting the student from completing courses
8
Upload any documentation that supports your request.
Drag and drop files here
Select files to upload
Cancelof
9
Provide any comments or explanations to support your request. What is your preferred resolution to this situation?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
10
Review Compassionate Withdrawal Policy* This field is required.This field is required. I have reviewed the Compassionate Withdrawal Policy on Mid's Website and understand that there are a number of factors that determine whether or not a Compassionate Withdrawal is appropriate for a student (ex. financial aid implications, loan payback, return of funds, etc.). In some cases, receiving a Compassionate Withdrawal may result in owing money to the College. The College requires that students discuss these factors with their Mid Mentor and Financial Aid before proceeding.
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