Modesto Junior College

REFUND REQUEST FORM

Name: ________________________________ Student Signature: _____________________________ Street: ________________________________ SSN or DP Number: __________________  City: ________________________________  Date:  __________________   State/Zip: ________________________________  Semester:      Summer      Spring      Fall   Is this a new mailing address?  Yes      No

YOU MUST DROP CLASS(ES) WITHIN THE REFUND PERIOD AT THE ADMISSIONS OFFICE, BY TOUCHTONE, OR VIA THE WEB PRIOR TO REQUESTING A REFUND

(A) Drop Deadlines: Enrollment Fees, Nonresident Fees, Health Fees, Student Center Fee, Material Fees and Student Representation Fees - Class(es) was/were dropped during the first two weeks of the term, except for short term classes. Short term classes must be dropped by the 10% point of the length of the class with the exception of those classes that have either five or fewer meeting days or 20 or less hours. In those cases the last refund date is defined as the day before the first class meeting. 
Student Activities Fee and Parking Fee - Class(es) was/were dropped by the last business day before the semester begins or by the last business day before the class begins if the class is a short term class. ASMJC stickers and parking sticker must be returned by the last business day before the semester begins or the day before the class begins in the case of a short term class, to be eligible for a refund.
(B) Refund Request Form: A Refund Request Form (available in the Business Services Office or Admissions Office) must be filed in the MJC Business Services Office by the end of the fourth week of the term, except for short term classes. Refunds for short term classes must be filed within two weeks of the start date of the short term class. As an alternative to filing the refund request in person, you may mail in your completed Refund Request Form to the MJC Business Services Office located at 435 College Avenue, Modesto, CA 95350; or you may fax the completed Refund Request Form to the MJC Business Services Office at (209) 575-6745. Community Education class participants file refund requests in the MJC Community Education Office, Morris Memorial Administration Building, Room 204.  In accordance to California Code of Regulations, section 58508, refunds with an enrollment credit of at least $10.00 will be assessed a $10.00 administrative processing fee.
(C) Outstanding Credit: Credit for which a refund has not been filed as specified in (B) above will not be refunded and may be lost. Continuing students with an outstanding credit can carry this credit from the summer and/or fall semesters into the succeeding fall and/or spring semesters where such credit is then applied against fees and charges in those respective terms. ANY CREDITS REMAINING AT THE END OF THE SPRING SEMESTER, HOWEVER, ARE FORFEITED, they are not carried into the next academic year.
(D) Classes Cancelled by the College: Refunds are made for classes cancelled by the College but REFUNDS ARE NOT AUTOMATIC. The student must submit a completed Refund Request Form to the Business Services Office.

If your refund is approved, it will be mailed to you approximately six weeks after the term begins or four weeks from the filing date, whichever is later. If fees were paid by check or credit card, the refund is not made until the funds have cleared the bank.

Check ALL Applicable Box(es)	Class Cancelled by College	Student Drop
Student Activities Fee	Parking Fee	Board of Governor's Waiver

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Amount Refunded ___________       Date Posted ___________      Authorized By ______________________ SDO/Warrant # _______