Office of Student Financial Aid & Scholarships
L.C. Barnes Administration Bldg., Rm A-43
3050 Martin Luther King, Jr. Drive
Shreveport, La 71107
Phone: (318) 670-9221 Fax: (318) 670-6336 Email: [email protected]
REQUEST TO CANCEL FINANCIAL AID
9000
Name: ___________________________________ Banner ID: ___________________
Please cancel my: (check all that apply) for the Summer I 2015 Semester.
Pell Grant
Stafford Subsidized / Stafford Unsubsidized Loan(s)
Other Aid: ________________________
I am cancelling my aid because (check all that apply):
I will not be attending college next semester
I will be attending ANOTHER school next semester and will be receiving aid there
I do not want a student loan
Other: (state reason below)
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Student Signature________________________________ Date____________________
Taken by: ___________________
F.A. Office Staff (please initial)
Southern University at Shreveport does not discriminate on the basis of race, color, national origin, gender or disability. Title IX Coordinator & Section 504
Coordinator: Ms. Jerushka Ellis, Fine Arts Building, Room C04 D, (318) 670-9473.
Revised 04/2015