Excelsior Scholarship Break in Enrollment and Reduced Credit Load Appeal

Recipients of the Excelsior Scholarship are required to maintain full-time enrollment and pass 30 credit hours per year toward their degree in order to maintain eligibility for the Excelsior Scholarship. Students who must take a break in enrollment or a reduced credit hour load may appeal these requirements if they meet certain conditions which made a break in enrollment or reduced credit hour load necessary. Allowable conditions for approval are: 1. A medical or mental health condition that prevents the student from beginning or continuing a term or continuing in a full-time courseload. 2. Parental leave 3. An interruption to care for an immediate family member whose health care provider determines care or support is necessary. 4. Death of an immediate family member. 5. A call to active military duty.

Last Name, First Name * Required
SUNY Poly ID # (starts with U00) * Required
Campus Email Address * Required
Phone Number * Required
Major * Required
First semester of enrollment at SUNY Poly * Required
Which Excelsior requirement are you appealing? * Required
- Break in Enrollment
- Reduced Credit Load
Explain in detail why it was necessary to take a break in your enrollment or to enroll in a reduced course load. Please note that you must have been on track to complete in 4 years (30 credit hours per year) prior to your break in enrollment or reduced credit hour load. It is also important to note that HESC has listed very specific conditions that are allowable for the appeal to be approved. * Required
Documentation of your condition is required in order for an appeal to be approved. Please upload the appropriate documentation which corresponds to your reasoning above.
Max. file size: 50 MB.
If this appeal is approved, explain your plan to continue to be on track to meet the 30 credit hour per year requirement of Excelsior. * Required
I understand that by submitting this appeal form, I certify that all of the information that I've provided is true and complete. I understand that I am applying for a one-time appeal of the enrollment and/or credit hour requirements of the Excelsior Scholarship program. I understand that the above documentation requirements are necessary for my appeal to be reviewed and that SUNY Poly has the right to request additional documentation. * Required
- Yes
- No
Captcha