Account Correction Worksheet
Your First Name:
*
Enter your first name
Your Last Name:
*
Enter your last name
Email Address:
*
Enter your email address
Affiliation
*
Student
Parent
Select your affiliation
Student's First Name:
*
Enter the student's first name
Student's Last Name:
*
Enter the students last name
Student's Middle Initial:
Enter the student's middle initial
Goucher ID#:
*
Enter the students Goucher ID
Semester
*
Spring 2018
Fall 2018
Spring 2019
Fall 2019
Amount due on Statement:
*
Enter the amount due on statement
Adjustments:
Enter a numeric value in each field, even if 0.
Meal Plan Change:
*
Enter meal plan change
Financial Aid:
*
Enter financial aid received
Other Scholarships/Awards:
*
Enter other scholarships/awards
Other:
*
Enter other aid amounts
Tuition Adjustment:
° 12 - 18 credits = $21,706
° Less than 12 credits = $1,448 per credit
° Over 18 credits = $21,706 + $1,448 per credit over 18
Adjusted Payment Due:
Total adjusted payment due
Explanation of Adjustments:
*
Please provide an explanation of adjustments
If you are human, leave this field blank.