1. No category

Student Financial Aid
TEACH Grant Cancellation
2015-2016 Academic Year
Student Name ______________________________
KSU ID# ___________________
Phone # ______________________
I request all of my TEACH Grant be cancelled for the following semester(s):
U
U
Fall Semester
Spring Semester
Summer Semester
Academic Year (fall/spring)
I request $________ be cancelled from my TEACH Grant for the following semester(s):
Fall Semester
Spring Semester
Summer Semester
Academic Year (fall/spring)
I hereby authorize Kennesaw State University to cancel or reduce my TEACH Grant as stated above. I agree and understand
that after funds have been removed from my account, it is my responsibility to check my Owl Express account. If there is a
balance due, based on the above transaction, I will pay the amount to the Bursar’s Office within 48 hours to avoid penalties.
Student Signature ________________________________________
Date ____________________________
******************************************************************************************************
I certify that the TEACH Grant has been cancelled or reduced at the student’s request and will be reported to
COD.
Financial Aid Representative Signature ________________________________________
Date _________________________
Printed Name _________________________________________________________
Title _________________________
Kennesaw State University, Office of Student Financial Aid, 585 Cobb Avenue NW, MD 0119, Kennesaw, GA 30144
Phone (770) 423-6074
Fax (470) 578-9096
Revised: April 2015