CAUTION Timeframe Appeal (80% of program units)
OFFICE USE ONLY
Student Section:
Date: ___________________________
(Name)_____________________________ ________________
Telephone Number
(Address)_________________________________
(City, State, Zip)____________________________
Reviewed by Jacque
Reviewed by Karen
CRI Approved
Denied
Image NOW
Ed Plan FMF Screen
SAPV
- LETTER
File Complete – AIDE/CK RUN
File Incomplete – SHELF
- TECH
C OPY to Student: ____________
- FILE RM
Rec’d by Martha
_____________________________________________
DATE
Student Email Address
The Department of Education allows financial aid to be paid for up to 150% of the student’s declared academic
program/major, if the student is successfully pursuing an academic goal: AA/AS, certificate, transfer.
A student can only be paid for required coursework to complete ONE program/major, unless he/she has been
pre-approved for two majors. Students are limited to 6 full-time years of pell grant in a lifetime – there is no
waiver.
You are required to complete this process because you have reached 80% of your goal. Follow these steps:
STEP 1:
Sign up for an “Evaluation Workshop” in the Financial Aid Office. DATE ATTENDED ___________
STEP 2:
Meet with a counselor to finish this appeal and to develop a Comprehensive Education Plan to
complete your FINAL goal so that you finish before reaching 150% of your program’s units. (If
you are unsure of your goal visit the Career/Transfer Center before meeting with a Counselor).
STEP 3:
Return this form to the Financial Aid Office and register for courses on your Education Plan
at least 30 days prior to the start of classes.
If approved the only courses that we can pay you for are those listed on the plan or that substitute. You are
expected to complete every class with a “C or better” grade (No Ws). Financial Aid will not pay you to retake
classes after this appeal has been approved.
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Counselor Section:
Has student changed their Academic Goal?
 Yes: Date of change _________________  No
Declared goal (circle): AA/AS Cert. Transfer
Major/Academic Program _________________________
Expected semester of completion for AA/AS or Certificate: _________Transfer _________ To: ___________
Cumulative GPA :________
Units completed that apply to AA/AS or Certificate _________________
Units still required to complete AA/AS or Certificate ______ Units still required to Complete for Transfer______
Plan include units for transfer to:  CSU
 UC
 Private
If the student plans to transfer, please attach an Education Plan that outlines the courses REQUIRED for the
student to reach their declared goal at Mendocino College. Students may take courses that are NOT required
for their goal; however, financial aid may only pay for REQUIRED courses that appear in college
catalogs, and articulation agreements. Financial aid can not pay for pre-requisites for multiple
schools.
Signature of counselor here certifies that all courses on the Education Plan are required for student’s goal:
Counselor Signature:____________________________________ Date:_______________________
APPROVED
FAC14CN1
DENIED
NEEDS APPOINTMENT