Southeastern Community College

Financial Aid Appeal

You must complete every field, including the Academic Plan, on this page. This appeal and Academic Plan will be reviewed by the Financial Aid Review Committee, and a response will be available normally within 7-10 business days. You will be provided a response via regular mail to your address on record at SCC. The decision of the Financial Aid Review Committee is final. Should your appeal be denied, a subsequent appeal will not be considered until you have successfully completed at least six credit hours on your own (without the assistance of financial aid).

First Name:

Middle Initial: enter 'X' if no middle initial

Last Name:

Last Four of SSN or Student ID Number:





Phone:  Please include area code

Please explain in detail the circumstances that contributed to your academic problems. You must demonstrate a "special circumstance" in order for your appeal to be considered. Please also state why you believe it is possible for you to improve your performance, and identify any corrective action you have taken. If you fail to state what has changed in your situation that will now allow you to make satisfactory progress your appeal will be denied.

What type of special circumstance is the basis of your appeal?

Student Injury or Illness (documentation required)

Illness, Injury or Death of a Family Member (documentation required)

Disaster (fire, flood, tornado, etc.)

Military Service Obligation (documentation required)

Divorce (documentation required)

Involuntary Change in Work Hours(documentation from employer required)

Recent Strong Academic Performance

Other Special Circumstances (documentation may be required)

The following circumstances will not be considered special conditions, or the basis for an appeal:

  • The passage of time(for example, your academic difficulties occurred in the past)
  • Classes too difficult
  • Not prepared to study/did not study enough
  • Poor instructor(s)
  • Transportation issues
  • Childcare/Daycare/Babysitting issues


Special Circumstance Explanation (what caused your academic issue):

Corrective Action (how has your situation improved):


Documentation to support your special circumstance must be provided to the Financial Aid Office. You may provide the documentation via hardcopy, fax or e-mail. Please make sure that all documentation submitted to the Financial Aid Office includes your printed name and student identification number (or last four of SSN). You must indicate on the document, within the e-mail or on the fax cover sheet that the documentation is being provided in support of an appeal. If the Financial Aid Office receives documentation without a name or student ID (or last four of SSN), it will be shredded/destroyed.

West Burlington:
P.O. Box 180
West Burlington, Iowa 52655
Fax: 319-758-6725

P.O. Box 6007
Keokuk, Iowa 52632
Fax: 319-524-8621

Do you plan on submitting documentation along with this appeal?
Yes No


Academic Plan Worksheet For Financial Aid Appeals (Required)



Plan End/Graduation Date:

Term requesting Academic Plan status (the next term you wish to receive financial aid)

Which campus do you attend? West Burlington Keokuk

Read and follow instructions in these boxes:


During each term you are on the Academic Plan status, you must meet with a Student Success Advocate (or designee). Failure to meet this requirement will result in suspension from the Academic Plan and loss of financial aid eligibility. To schedule your appointment, call one of the following numbers:

West Burlington Campus - 319.208.5155
Keokuk Campus - 319.313.1943


  • Initials:  Minimum Term GPA Equal to or Above: 2.25
  • Initials:  Minimum Term Completion Rate Equal to or Above: 75%*
  • Initials:  Each measure must be maintained until graduation, or until cumulative Satisfactory Academic Progress is achieved by the student.
  • Initials:  Meet with a Student Success Advocate throughout the requested term.

* Maximum timeframe remains 150% of the published length of the student's program of undergraduate study.

By typing your name in the box below and clicking "Submit", you acknowledge that you have read and agreed to the above plan in order to successfully complete the course of study in which you have enrolled. You understand that this plan must be adhered to and cannot be altered once submitted and approved. Failure to follow this plan will result in dismissal of federal student aid and require that all courses taken be paid for at the student's expense.

By typing your name in the box below and clicking "Submit", you certify that all information and documentation you have submitted pertaining to this appeal is true and complete. You also agree to the terms and conditions set forth in the Academic Plan identified above.

Full Name: