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Office of Financial Planning, 1450 Alta Vista, P.O. Box 178, Dubuque, IA 52004-0178 (563) 588-7136 SPECIAL CIRCUMSTANCES REQUEST FORM 2015-2016 Student s name: SSN: Student s Home Address Student
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How to fill out special circumstances request form:

01
Start by obtaining a copy of the special circumstances request form. You can typically find this form on your school or organization's website, or you may need to request it from the appropriate department.
02
Read the instructions carefully before filling out the form. This will ensure that you understand the process and provide all the necessary information.
03
Begin by providing your personal details, such as your name, contact information, and any relevant identification numbers or student IDs.
04
Clearly state the reason for your special circumstances request. Whether it's a medical condition, family emergency, financial hardship, or any other qualifying circumstance, clearly explain the situation in a concise and respectful manner.
05
Attach any supporting documents or evidence that support your request. For example, if you're requesting financial assistance, you may need to include bank statements or tax documents to support your claim.
06
If the form includes specific sections or questions related to your circumstances, be sure to answer them accurately and thoroughly. This will help expedite the review process and increase your chances of having your request approved.
07
Review the completed form for any errors or missing information. Double-check that you have signed and dated the form before submitting it.
08
Submit the form through the designated channel. This could be an online submission form, an email address, or in person at a specific office or department. Follow any additional instructions provided to ensure your request is properly received.

Who needs a special circumstances request form:

01
Students: Students who are facing unexpected challenges, such as a serious illness, injury, or personal/family emergency, may need to fill out a special circumstances request form to request any necessary accommodations or adjustments to their academic or financial situations.
02
Employees: Employees who find themselves in unique circumstances, such as sudden health issues, caregiving responsibilities, or financial struggles, may be required to complete a special circumstances request form to inform their employer and seek appropriate support or accommodations.
03
Individuals seeking assistance: Anyone who requires assistance or accommodation due to extenuating circumstances may need to fill out a special circumstances request form to formally communicate their needs and seek the necessary help.
Remember, the specific requirements and processes may vary depending on the organization or institution, so it's important to refer to the instructions provided with the form and seek any additional guidance if needed.
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Special circumstances request form is a form used to request an exception or special consideration based on unique or unforeseen circumstances.
Individuals who believe they have valid reasons for special consideration are required to file a special circumstances request form.
Special circumstances request form can be filled out by providing detailed explanations of the circumstances, supporting documentation, and any other relevant information.
The purpose of special circumstances request form is to allow individuals to explain their unique situations and request special consideration or exemptions.
The information required on a special circumstances request form may include personal details, explanation of circumstances, supporting documents, and any other relevant information.
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