Cost Of Attendance Appeal Form
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1
2Aloysius P. Kelley Center
1073 North Benson Road
Fairfield University
Fairfield, CT 06824
Office of Financial Aid
(p) 203.254.4125
(f) 203.254.4008
(e)
finaid@fairfield.edu
(w)
Cost of Attendance Appeal Form
Academic Year: 20 ________ - 20 ________
Fairfield ID# ______________________
Student Last Name ________________________________
First Name ________________________________
E-mail _______________________________________@ ________________
Home Phone ______ - ______ - ______ Cell Phone ______ - ______ - ______ Work Phone ______ - ______ - ______
In order to expedite the processing of your financial aid, please complete the following form and attach a personal
statement requesting a review of the standard cost of attendance. Please provide supporting documentation as
requested*. Your appeal will not be reviewed until all required documents are received.
With this form, I am requesting a Cost of Attendance Appeal for (please indicate year):
FALL __________
SPRING __________
SUMMER __________
SOURCE
MONTHLY EXPENSE
SOURCE
MONTHLY EXPENSE
Rent/Mortgage
Gas (heat/hot water)
Electric
Oil
Phone/Cable/Internet
Health Insurance
Car payment
Auto Insurance
Childcare
One-time computer
Homeowners Insurance
Property taxes (home)
Property taxes (car)
Water
Sewer
Other**
* Provide a current rental/lease agreement or a current mortgage statement.
* For all utilities, provide 6 months worth of billing statements for each.
* Childcare expenses must be incurred solely due to full time enrollment in school. Provide tuition contract and/or receipt.
* Students are allowed to include a one-time computer purchase for his/her program. Provide receipt of purchase.
* Please provide monthly or quarterly receipts for each other expense listed above.
** Please define “OTHER” in your personal statement and provide supporting documentation.
11/10; 01/12; 03/12
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Parent category: Financial