Cost Of Attendance Revision Request Financial Aid And Scholarships Page 2

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ADJUSTMENT TO STUDENTS COST OF ATTENDANCE INFORMATION
Student Medical or Dental Expenses: (
Request may be approved for up to $2500)
1. Attach copies of receipts documenting your out-of-pocket cost for medical procedures.
2. Required medical or dental procedures of the student that are not covered by insurance may be considered.
3. Provide documentation of insurance premium or lack of insurance coverage and the necessity of the procedure being billed.
4. An itemized listing of medical bill(s) being requested noting the procedures and cost.
Student Request to be considered Living Off-Campus Room & Board: (
Request may be approved for Off-
Campus Room & Board)
1. Attach a written statement and address of Off-Campus residence.
Request may be approved up to $1400)
Computer Expense: (
1. Attach copies of itemized receipts or estimate of intent to purchase
2. You may claim a one-time computer cost for educational purposes.
3. Payment or reimbursement will occur over your expected enrollment period.
NOTE: You may receive a one-time adjustment to your student expenses for a computer purchase for educational purposes.
Child Care Expense:
1. Dependent children must live with you and be 12 years of age or younger.
2. List names, age and child care cost incurred for each one.
3. Attach documentation from your child care provider with the number of hours, days, and weeks that care is provided and
the amount charged. Rates should reflect standard cost for your community.
4. Provide the source and amount of child care subsidy you receive.
NOTE: Only one parent may request child care cost if both parents are attending college.
Commuting Expense for Student:
1. Indicate the address to where you will be commuting.
2. A standard commuting allowance based on the State of Oregon mileage rates will be used to determine cost. The city in
which you reside will be used in this mileage calculation.
• Tuition/fee Review:
1. Differential tuition/fees or required program costs
MISCB – Department use only

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