The University of Toledo s3

THE UNIVERSITY OF TOLEDO

Rocket Card Withdrawal Request

Guidelines:

 Rocket Card withdrawal request will only be processed provided a student has funds available to withdraw  Any eligible funds withdrawn may be applied to an outstanding student account balance from the current aid year, prior to any refund to the student  Student refunds are distributed via direct deposit to the account designated by the student (please make sure you have provided this information prior to completing this form). NO CASH Refunds are issued.  Withdrawal requests will begin to be processed after the add/drop period ends  Submit completed forms to:

The University of Toledo Rocket Solution Central, Rocket Hall, Room 1200 2801 W. Bancroft St. Toledo, OH 43606

Date of Request: Rocket Number: R

Student’s First Name: Middle Initial: Last Name:

University email: @rockets.utoledo.edu

Telephone Number: Address:

Type of Withdrawal: Financial Aid Rocket Dollars

Amount: Specific Amount $ Remaining Balance

______Student Signature