Revised SAP Application with required fields 1015

Satisfactory Academic Progress Financial Aid Appeal Form
Student Success Academy (SSA)
1650 Bedford Avenue,Brooklyn, NY11225

Telephone: (718) 270-6911

Email:SAP@mec.cuny.edu
Dear Student,

A student may appeal the suspension of his or her financial aid eligibility resulting from failure to meet the Satisfactory Academic Progress criteria by submitting this form, along with supporting documentation by the appropriate deadline. Appeals received after the deadline date will not be considered. Only appeals with documented extenuating circumstances will be considered, so be sure to submit all required documents. Please note, the sole submission of this document does not guarantee approval of any Federal Aid that may be affected by SAP, and once processed, all decisions will be final.
The completed form will be presented to the Satisfactory Academic Progress (SAP) Policy Committee for SAP appeals. Your appeal request must include the following items to be considered complete:
- This appeal form must be initialed electronically and dated.
- A detailed personal statement explaining the circumstances that caused you to fall below the minimum academic requirements for financial aid; the date(s) the circumstances occurred and how you were affected personally and academically; what has changed and your plan for ensuring that you can and will meet SAP requirements by the next semester; any other supporting document you wish to include. The personal statement must be typed, and all supporting documents must be scanned and submitted along with your application
Personal Information *

First Name Last Name
EMPLID *
Address

Street Address

Street Address Line 2

City, State, Zip Code
Your Medgar Evers College email *
Advising Units (Please indicate your Advising Unit) *

ASAP SEEK FYP (Freshman Year Program) AAC (Academic Advisement Center) Education
Which semester are you applying for? *

Spring Summer Fall
Please indicate your Major *
Name of Advisor
Please indicate the extenuating circumstances that contributed to your inability to maintain Satisfactory Academic Progress by checking the category below that applies to you. Please follow the instructions for each category. *

Death of an immediate family member spouse, child, sibling, or parent. Attach a copy of the death certificate or obituary and include the name of the deceased and relationship to you. Serious injury or illness to student or immediate family member (spouse, child, sibling, or parent) that required extended recovery time. Attach a statement from the physician and explain the nature and dates of the injury or illness. Significant trauma in student’s life that damaged the student’s emotional and/or physical health. Provide a detailed explanation and be sure to include dates and what you have done to overcome this situation. Supporting documentation from a third party physician, social worker, psychiatrist, law enforcement official, etc must be attached. Suspension due to exceeding the maximum allowable time frame for completing a program of study. Provide a detailed explanation. Supporting documentation must also be provided. Other unexpected documented circumstances beyond the control of the student. Provide a detailed explanation, with supporting documents.
In 250 words or less, please provide further detail on the circumstance(s) highlighted above *
Appeal Process Instructions
Step One

Contact your Academic Advisor to confirm that an academic plan for the upcoming semester has been completed on your behalf. (Please ensure you have included the name of your Advisor and your Advising Unit.)
Step Two
- S ubmit this completed application by pressing the submit button below and submit any additional supporting documents to SAP@mec.cuny.edu .
Read the following statements carefully and initial them. Your initials certify that you have read and understand all the information on this form.
Confirmation
I understand submitting an appeal does not guarantee an approval or financial aid reinstatement. As such, I am responsible for my balance. *
I understand that it is my responsibility to check the status of the outcome of my appeal. *
Date: *

Month Day Year
Date
FOR SAP COMMITTEE USE ONLY
Individualized Academic Plan for Title IV (Federal Pell)
Satisfactory Academic Progress Financial Aid Form
Student GPA
Individual advising session suggested academic plan:

No Plan Needed - SAP standard can be met in one semester. (Complete the table below detailing required course of action.)
Plan Needed – SAP standard can be met in two semesters. Complete table below detailing suggested courses
Should be Empty:

Satisfactory Academic Progress Financial Aid Appeal Form

Appeal Process Instructions

Step Two

Confirmation

FOR SAP COMMITTEE USE ONLY

Individualized Academic Plan for Title IV (Federal Pell)

Satisfactory Academic Progress Financial Aid Form