Tuition Credit Request Cover Page

Student First Name: _____________________________ Student Last Name: _____________________________

Student ID (ABCDEF1234): ____________________________________ Date: ____________________________

Student Advisor’s Name: ________________________________________________________________________

*Please note this cover page must be submitted with your completed Tuition Credit Request form AND supporting documentation. Requests submitted without this cover page may delay the processing of your request. (In order for
Student Records to process this request, the cover page, the form, and the supporting documentation will need to be submitted as one attachment.)

Tuition Credit Request
Revised 8/5/14
Please contact your Student Advisor for assistance in filling out this form prior to submission. Print, sign, and submit this form via email with official documentation as one attachment to student.forms@ashford.edu or fax to 888.481.7811.
Note: Please review the accepted form formats: .PDF, Word (.DOC or .DOCX), Excel (.XLS or .XLSX), TIFF or .TIF, .JPG or .JPEG,
Text (.TXT), Bitmap (.BMP), .HTML or .HTM. Submitting a form in any other format may require resubmission or result in a delay in processing. Forms submitted that are not legible will not be processed.
If you are experiencing extreme temporary hardship resulting in the need to drop a course, you may request a tuition credit. In order to apply for a tuition credit, you must submit this completed form with official documentation within 60 days from your last date of attendance in the dropped course. Requests made more than 60 days after your last date of attendance require additional documentation and explanation. The documentation/explanation must support why the form was not submitted within the 60 day timeframe. Forms received more than 60 days from the last date of attendance of the selected course without this documentation may cause delay in processing or possible denial of the request.
The grade currently assigned to the course must be either W or WF. If you have earned a letter grade in the course, such as F, you should instead submit a Grade Appeal. Once your Grade Appeal is approved, a tuition credit will be applied to your account.
A tuition credit may be approved and applied for the following documented reasons that directly impacted your ability to continue in the course or program during the timeframe in which the course occurred:
Documented military deployment that resulted in an inability to continue in the course or program*
Documented emergency personal or family medical reasons (5102)
Authorized accommodations on file
Documented act of nature (5103)
Documented death in the immediate family** (5104)
Documented temporary severe economic hardship (5105)
Additional documented extenuating circumstances may also be considered.
*If you have experienced military deployment that resulted in an inability to continue in the course or program you should instead complete and submit a Military Course Drop or Incomplete Request.
**Immediate family is defined as husband, wife, grandchildren, (step/adoptive) mother, (step/adoptive) father, (step/adoptive) brother,
(step/adoptive) sister, (step/adoptive) child, mother-in-law, father-in-law, brother-in-law, sister-in-law, daughter-in-law, son-in-law, or grandparent. Approval of this request does not result in the removal of the “W” or “WF” grade issued, as per University policy. “W” and “WF” grades are applied to and count negatively toward satisfactory academic progress requirements.

Student Information
First Name: _________________________________________ Last Name: ______________________________________________
Student ID (ABCDEF1234): _____________________________________ Phone: _________________________________________
Reason for request: (documentation must be attached with Student ID written on each page)

Course Dropped
Course Number: _________ Course Title: ___________________________________ Start Date: __________ End Date: __________

Required Authorization

I understand that if my Tuition Credit Request is not approved, I will be responsible for all course charges incurred, as well as any tuition charges beyond the approved credit amount authorized via this form.
Student Signature: _______________________________________________________________ Date: ________________________
Electronic signature not accepted