Request for Early Disbursement of Funds

Name*

First Last

Student ID #:*

Email*

Funds Requested for Semester:*

Year:*

Check all that apply:

My first course for at least 3 credits begins on:*

*

I request an early disbursement of my Sierra Nevada University financial aid funds to my student account. By signing this form, I promise to repay Sierra Nevada University any funds due which are the result of a complete withdrawal from classes. I will be held responsible for any tuition changes that are a result of adding or dropping courses, or any additional charges added to my student account after receiving the early disbursement funds.

Signature*