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Must be 7 characters. Currently Entered: 0 characters.
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Student Type *
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Which program do you attend: *
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I plan to waive or have waived the university health insurance: *
Checking this box does not mean the health insurance has been waived. You can complete the waiver at universityhealthplans.com
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Please cancel my loan for the: *
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Which loan(s): *
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Please adjust my loan for the: *
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Please adjust my loan to: *
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Please specify your requested refund or balance due per semester.
For example:
Fall 2022: $1,000
Spring 2023: $500
Summer 2023: $500
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Enrollment Plans
Please enter the number of credits for which you will enroll at Simmons during each semester. Enter 0 if you will not/did not enroll for a given semester.
Please note, you must enroll in 5+ credits as a graduate student, and 6+ credits as an undergraduate student per semester, to be eligible for federal student loans in a given semester.
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This should be the signature for the person who is borrowing the loan. Most often, this is the student. If the loan is a parent PLUS loan, then the borrower is the parent.
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Agreements
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I acknowledge that by signing this form I understand and agree to the following statements *
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