Loan Adjustment Form 2023-2024

Please note, if your loan has already disbursed, we can no longer reduce it, and you must contact your loan servicer to reduce the loan.

Student Name Student Name First Last
Student ID Number
Must be 7 characters. Currently Entered: 0 characters.
Simmons Email
Student Type

Student Type Undergraduate Graduate
Which program do you attend:

Which program do you attend: On-Campus Undergraduate or Graduate Program Online Undergraduate-Complete Degree Program Online Graduate-Library Science or Nutrition Online Graduate-Social Work, Nursing, or Behavior Analysis Online Graduate-Public Health
I plan to waive or have waived the university health insurance:

I plan to waive or have waived the university health insurance: Yes No

Checking this box does not mean the health insurance has been waived. You can complete the waiver at universityhealthplans.com
Loan Type
Lender/Bank Name
I would like to:
Please cancel my loan for the:

Please cancel my loan for the: Year (Fall 2023 - Summer 2024) Term/Semester
Which loan(s):

Which loan(s): Subsidized Unsubsidized
Please adjust my loan for the:

Please adjust my loan for the: Year (Fall 2023 - Summer 2024) Term/Semester
I would like to cancel my loan for the following semester
I would like to adjust my loan for the following semester
Please adjust my loan to:

Please adjust my loan to: Cover my balance only Give me a refund of Leave a balance due (that I will pay out of pocket) of
Desired Dollar Amount Per Semester:

Please specify your requested refund or balance due per semester.

For example:
Fall 2022: $1,000
Spring 2023: $500
Summer 2023: $500
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.
Fall 2023 - Number of Credits
Spring 2024 - Number of Credits
Summer 2024 - Number of Credits
Loan Borrower Name Loan Borrower Name First Last
Today's Date Today's Date / MM / DD YYYY
Loan Borrower Signature:

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.
Agreements
I acknowledge that by signing this form I understand and agree to the following statements

I acknowledge that by signing this form I understand and agree to the following statements All information provided is complete and accurate to the best of my knowledge. I will promptly submit any additional documentation requested by Student Financial Services. Omitting or misreporting information on this form may result in a change or delay to my financial aid. I will immediately notify SFS in writing if any information on this form changes and understand the change may impact my eligibility for aid. In the event that I do not notify SFS of a change in my enrollment plans, my actual enrollment will be reviewed at the beginning of the term and my financial aid will be adjusted at that time, if necessary. I understand that if my loan has already disbursed, SFS may not be able to adjust/cancel my loan and I would instead need to contact my loan lender.

Loan Adjustment Form 2023-2024

Loan Adjustment Form 2023-2024

Enrollment Plans

Agreements