TUITION / FEE APPEAL FORM – UNLV Student Accounts Office

Date:     

Last Name                               First Name                              MI                                           L Number

Address                                               City                                         State                            Zip

Phone                                                                                      E-mail address

What are you appealing?        

Justification for appeal:          

Student Signature                                                                               Date

Upon completion of this form, please mail, fax or hand-carry with your documentation to:

UNLV Student Accounts Office

4505 Maryland Parkway – Box 451015

Las Vegas, Nevada 89154-1015

Fax: (702) 895-0695

Action taken by Committee:  Approved                             Denied                                       Date   

Comments: