SFS Request for Consideration of Special Financial Circumstances

Request for Consideration of Special Financial Circumstances

Gordon College Student Financial Services (SFS)
Academic Year

2024-20252025-2026
Selected Academic Year
Academic Year -1
Academic Year -2
Student First Name*
Student Last Name*
Student ID Number*
Parent First Name*
Parent Last Name*
Parent Email*
example@example.com
Parent Phone Number*
Please enter a valid phone number.
Parent AGI Information

Adjusted Gross Income (AGI) is defined as gross income minus adjustments to income.

This information can be found in line 11 of the IRS Form 1040.
{academicYear-2} AGI*
{academicYear-1} AGI*
Estimated {academicYearFirst} AGI*
Type of Hardship Incurred*

Job Loss/ChangeRetirement of a ParentOne-time Distribution of IncomeHigh Medical/Dental ExpensesOther
Detailed Reason for Request*
The FAFSA collects information from the prior, prior tax year. However, some families have had situational changes that render that information inaccurate as a current representation of the family's finances. Please describe your situation (be as specific as possible), so that we can determine if an adjustment may be warranted, and request the appropriate documentation to support the adjustment.
By signing below;
1. I acknowledge that the above information is correct and accurate to the best of my ability
2. I verify that I am requesting this consideration on behalf of myself or my dependent (the student in question)
Signer's Relationship to Student*

Parent of the student listed aboveStudent listed aboveOther
Signer Email*
Please enter the email address of the person who is filling out and signing this form
Signature*

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