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EOPS Denied Services Appeal Form

Date of Appeal   
Student ID
Student Name
Email

Reason for Appeal

   

Why do you think EOPS should reconsider your denial for services?

   

I affirm that all information on this form is true and complete.  I realize that any false statement will cause for denial, reductions, withdrawal, and/or repayment of monetary services in which I receive from the EOPS program.