Student Accounts Refund Request Form | College Finance

Name *

Please enter both your first and last names.

Complete Mailing Address *

Include city, state, and zip code. Be sure your address is current in myLane so if your refund is approved and you have a credit balance it will be mailed to your current mailing address.

L number *

Date of Birth *

Phone Number *

(555) 555-5555

Email *

Is your account currently in collections? *

Yes

No

Mark each that applies to your Refund Request

I added and dropped the class(es) the same day

I did not receive financial aid for the class(es)

I received financial aid for the class(es)

My Lane account is in collections

I dropped the class(es) I am requesting a refund for

I no longer have the option to drop the class(es) in myLane

If receiving financial aid, list the last day of attendance *

What term are you requesting the refund for? *

List the CRN(s) and Name(s) of class(es) requesting a credit tuition refund

CRN and Course Name for each class.

Write a statement why you are requesting a refund. You must drop your class(es) before submitting a refund request unless you no longer have that option (after the eighth week of the term). After week one and before the end of week eight, you will need to select 'drop NO refund' in myLane.

You must either submit documentation in person/by mail OR by attaching supporting documentation to this form (see below). All documentation must be received by ESFS within 14 days of refund request. If documentation is not received within 14 days and your refund request is reviewed, it will be automatically denied. Please mark which option you will be using to submit the required documentation: *

Attaching supporting documentation using fields below

Submitting supporting documentation by mailing to address below

Submitting supporting documentation in person to Enrollment and Student Financial Services

The class(es) were added and dropped the same day so no documentation needs to be submitted

You can submit documentation in person to Enrollment and Student Financial Services in the lobby of Building 1 on main campus.

OR

Mail documentation to:
Lane Community College
PO Box 50850
Eugene, Or 97405-0099

By submitting this request, I understand that:

Request for refunds are considered only for circumstances clearly beyond a student's control. Transportation fee is non-refundable. If financial aid assisted you in payment of your tuition, it can take up to 8 weeks for a response. Any refund is first applied to your account if any term has a balance effective that date. After funding your account, any overpayment will be refunded to you. Notification will be emailed to you.

Lane Community College Refund Policy

I have read and understand the LCC refund policy. *

Yes