FinAid: Unusual Enrollment History Form

Form Name Hidden
Office of Student Financial Aid
Division of Student Engagement & Enrollment Services
2002 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-3683 ● Fax: (757) 683-5920
Unusual Enrollment History Form
Academic Year *
Your 2024-2025 Free Application for Federal Student Aid (FAFSA) has been flagged for "Unusual Enrollment History Review" by the U.S. Department of Education because you received Federal Pell Grant and/or Federal Student Loan funds at multiple education institutions during the review period of 2020-21, 2021-22, 2022-23, and 2023-24. This flag requires the Financial Aid Office to review your enrollment history and determine if you are enrolling for a legitimate educational purpose. The Financial Aid Office will check the National Student Loan Data System (NSLDS) to obtain a complete enrollment history. Students will not qualify for financial aid until the Unusual Enrollment History flag is resolved.
Student Information:
Student Name Student Name * First Middle Last
Student UIN *
Must be 8 characters. Currently Entered: 0 characters.
Date of Birth Date of Birth * / MM / DD YYYY
Contact Number Contact Number * - ### - ### ####
Student Address Student Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Student Email *
Colleges and Universities Attended

Please list all institutions attended during the academic periods of 2020-21, and 2021-22, 2022-2023, and 2023-24. You must submit a copy of all academic transcripts for all colleges/universities attended (official or unofficial) with this form. Attach a signed explanation for the schools where you did not earn any academic credit. Attach any supporting documentation (i.e. medical documentation, police reports, military
obligations, etc.) that supports your reason for withdrawal. Your application for financial aid will not be considered until you submit this completed form and all required documentation to the Financial Aid Office.
Name of College or University #1
From Date From Date / MM / DD YYYY
To Date To Date / MM / DD YYYY
Name of College or University #2
From Date From Date / MM / DD YYYY
To Date To Date / MM / DD YYYY
Name of College or University #3
From Date From Date / MM / DD YYYY
To Date To Date / MM / DD YYYY
Name of College or University #4
From Date From Date / MM / DD YYYY
To Date To Date / MM / DD YYYY
Please upload ALL supporting documentation in PDF format ONLY. Be sure your Student UIN is on each page. *

Attach Files
Certification and Signature

By signing below, I certify that all information reported on this form is complete and accurate. I further agree to submit any other requested documentation to substantiate this request. I understand that if I purposely give false or misleading information and/or fraudulently sign this form, I may be fined, sentenced to jail, or
both.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
PLEASE ALLOW 3-4 WEEKS FOR PROCESSING/REVIEW.
Old Dominion University is an equal opportunity, affirmative action institution. Minorities, women, veterans and individuals with disabilities are strongly encouraged to apply

FinAid: Unusual Enrollment History Form

Office of Student Financial Aid Division of Student Engagement & Enrollment Services 2002 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-3683 ● Fax: (757) 683-5920

Student Information:

Colleges and Universities Attended

Certification and Signature

Office of Student Financial Aid
Division of Student Engagement & Enrollment Services
2002 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-3683 ● Fax: (757) 683-5920