Name_____________________________________________________________________

ID Number: ___________________ SS Number: _________________________

Number of Hours Attempting:

Maymester __________ Summer III __________

Summer I __________ Fall __________

Summer II __________ Spring __________

I understand that my financial aid and/or loans will be adjusted, if necessary, as possible and that I will be notified by mail after the adjustments have been made.

Student’s Signature Date____________________________________________________________________

Please return this completed form to the following address:

Office of Financial Aid, Division of Student Affairs, 225 Martin Hall, P. O. Box 6905, Radford University, Radford, VA 24142 (540) 831-5408 or you may FAX (540) 831-5138.