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Office of Financial Planning 1450 Alta Vista, P.O. Box 178 Dubuque, IA 520040178 563.588.7136 SPECIAL CIRCUMSTANCES REQUEST FORM 20162017 Students name: SSN: Students Home Address Students Home Phone
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How to fill out the special circumstances request form:

01
Start by obtaining a copy of the special circumstances request form. This form is typically available on the official website of the organization or institution that requires it. You may also be able to obtain a physical copy from their office.
02
Carefully read the instructions provided on the form. It is crucial to understand the specific requirements and guidelines before filling out the form. This will ensure that you provide accurate and complete information.
03
Begin by providing your personal information. This may include your full name, contact details, identification number, and any other information requested. Make sure to double-check the accuracy of the information before proceeding.
04
Identify the type of special circumstances you are requesting. This could include financial hardships, medical conditions, family emergencies, or any other valid reason that may affect your situation. Be sure to select the appropriate option and provide additional details if required.
05
Provide supporting documentation to strengthen your case. This may include medical records, financial statements, legal documents, or any other relevant evidence. Make sure to include copies of these documents with your form, keeping the originals for your own records.
06
Write a clear and concise statement explaining your special circumstances. Use this opportunity to explain how these circumstances have impacted your ability to meet the standard requirements or expectations. Be honest and provide enough detail for the reader to understand the situation.
07
Review the completed form and supporting documents. Double-check for any errors or missing information. It is essential to submit an accurate and complete form to avoid delays or rejection.

Who needs a special circumstances request form:

01
Students: Students who are facing challenging situations that may affect their academic performance or participation in extracurricular activities may need to fill out a special circumstances request form. This could include personal or family emergencies, health issues, or financial difficulties.
02
Employees: Employees who require accommodations or adjustments due to personal circumstances, such as health issues or family responsibilities, may need to complete a special circumstances request form. This form may be necessary to initiate discussions with the employer about potential modifications to their work arrangements.
03
Applicants: Individuals who are applying for certain programs or benefits may be required to submit a special circumstances request form. This could include scholarship applications, financial aid requests, or housing assistance applications. The form allows applicants to explain any extenuating circumstances that should be considered in the evaluation process.
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Special circumstances request form is a document used to request exceptions or accommodations under unique situations.
Individuals who are facing unique situations that require exceptions or accommodations are required to file special circumstances request form.
Special circumstances request form can be filled out by providing detailed information about the special situation, reasons for the request, and any supporting documentation.
The purpose of special circumstances request form is to allow individuals to request exceptions or accommodations under unique situations that may not be covered by standard procedures.
Information such as the detailed description of the special situation, reasons for the request, and any supporting documentation must be reported on special circumstances request form.
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