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Request for Refund

General Information

Please provide the following general information. Information in bold is required.


First Name	Last Name	MI

E-mail Address
Extension/Phone
Student ID
Room Number Type COM if commuter.
Semester

Request for Refund

Please note, refund requests must be received by Friday, 5PM in order for a check to be processed on the following Friday.
Refunds at the beginning of a semester will be processed after the Registration add/drop period concludes.

Please provide the following information about your refund request.

Please provide name, address, and phone number of refund recipient.

Name:
Address:
Phone (at that address):

Choose from the following two refund amount options.
	Refund Amount Option 1: I request to have the total credit balance of my tuition account refunded.
	Refund Amount Option 2: I request to have a portion of the credit balance of my account refunded.
	If option 2 is selected, please enter amount here:

Choose from the following three refund receiving options.
	Refund Reception Option 1: Send the refund check to the address I provided above.
	Refund Reception Option 2: Send the refund check through campus mail to the student.
	Refund Reception Option 3: Hold the refund check in the SAS Office.
	Refunds are available after 4PM on Friday, at the SAS front desk. Checks that are not picked up will be mailed the following Tuesday.