Undergraduate Aid Review for Loss of Income 2024-25 Academic Year

This form is used to request a second review of your financial aid eligibility based on a change in your financial circumstances. If a parent has suffered a job loss or some other difficult circumstance, please provide information below so we can determine whether we can help. We want to be helpful, but we also must be realistic in assessing your circumstances. Revisions can be considered only if one of the criteria shown below are met.

Before completing this form we strongly suggest you speak with a financial aid counselor. Our counselors will help review your situation and provide guidance regarding the information and documents to include.

International students should *not* complete this form. (You will not receive a response.) Instead, please email us at undergradaid@u.northwestern.edu.

Once we review your request, we will contact you by email at your Northwestern email address.

Northwestern ID Number
Must be 7 digits. Currently Entered: 0 digits.
Please enter the student's 7-digit numeric ID number.
Student Name Student Name First Last
Student Email

Confirm Email Address

Please use the student's Northwestern email address.
Parent 1 Email

Confirm Email Address
Parent 2 Email

Confirm Email Address
2024-25 Academic Year Aid Review for Loss of Income: Type of Situation

Your response to the questions in this section will help guide you in submitting your request. Please respond to all of the questions in this section. Select "Yes" for the category that best describes your situation. You may select more than one, if applicable. Please complete all fields related to your choice, and attach all requested documentation.
A parent had a change in employment status or income

A parent had a change in employment status or income Yes No
Please indicate the type of change in employment:

Please indicate the type of change in employment: Loss of Job Other change causing an income reduction
A parent received untaxed income that has stopped or been reduced in 2023 (for example child support).

A parent received untaxed income that has stopped or been reduced in 2023 (for example child support). Yes No
Your parents have separated or divorced since the original application for financial aid.

Your parents have separated or divorced since the original application for financial aid. Yes No
There were extraordinary medical expenses in 2022 that were not reimbursed by insurance.

There were extraordinary medical expenses in 2022 that were not reimbursed by insurance. Yes No
There were extraordinary medical expenses in 2023 that were not reimbursed by insurance.

There were extraordinary medical expenses in 2023 that were not reimbursed by insurance. Yes No
Besides those decribed above, do you have other circumstances to report in this form?

Besides those decribed above, do you have other circumstances to report in this form? Yes No
Please describe your circumstances that are not within one of the categories described above.

This box has appeared because you have answered "yes" to the "other circumstances" question above.
If none of the circumstances described above apply to you, please upload a letter explaining your situation along with any other substantiating documentation.

Attach Files

This box has appeared because you have answered "yes" to the "other circumstances" question above. IF you are unsure of what documentation to submit, please consult with a financial aid counselor prior to submitting your request to avoid processing delays.
Divorce/Separation

This section describes the additional information required when you have reported your parent(s) has become divorced or separated.
Please attach a copy of the separation or divorce decree. If you do not have a formal separation agreement, please provide documentation of separate residences (utility bill or lease/mortgage for both).

Attach Files
Please upload a copy of your parent(s) 2022 and 2023 federal tax documents

Attach Files

If you have already submitted the parent(s) 2022 federal tax documents, you do not have to re-submit them.
Please upload a copy of your parent(s) 2022 and 2023 W-2s

Attach Files

If you have already submitted the parent(s) 2022 W-2s you do not have to re-submit them.
Are/will the parent receive unemployment compensation?

Are/will the parent receive unemployment compensation? Yes No
Please upload documentation of unemployment compensation.

Attach Files
Please upload a copy of termination letter or statement of change in salary from your employer. (Include severance letter as well, if applicable.)

Attach Files
Please upload a copy of your oficial year-to-date earnings statement (payroll summary or pay stub).

Attach Files
Medical Expenses
Explanation of medical expenses not covered by insurance
Please upload documentation of outstanding/prior year medical bills not reimbursed by insurance

Attach Files
Loss of Untaxed Income
Please describe the nature of the loss of untaxed income
Please upload any documentation substantiating the loss of untaxed income

Attach Files
Projected Parent Income 2023 and 2024

Please complete all fields below
Please describe circumstances here

In the event of job loss, please wait 8-10 weeks before submitting this form.
Parent 1 Name: Parent 1 Name: First Last
Expected wages earned by Parent #1 for calendar year 2024: $ Dollars . Cents
Parent 2 Name: Parent 2 Name: First Last
Expected wages earned by Parent #2 for calendar year 2024: $ Dollars . Cents
Expected Severance in calendar year 2024: $ Dollars . Cents
Expected Unemployment Benefits in calendar year 2024: $ Dollars . Cents
Expected Worker's Compensation in calendar year 2024: $ Dollars . Cents
Expected Interest/Dividend Income in calendar year 2024: $ Dollars . Cents
Expected Child Support in calendar year 2024: $ Dollars . Cents
Expected Social Security Benefits in calendar year 2024: $ Dollars . Cents
Expected Payments to Tax Deferred Plans in calendar year 2024: $ Dollars . Cents
Expected Other Income in calendar year 2024: $ Dollars . Cents
Describe source in text field above.
Certification and Signature

Parent Certification Statement: By typing my name and checking the box below, I certify by electronic signature that I am a parent of the above named student and, to the best of my knowledge, the information I have provided on this form and any documentation I am providing to support this information is true and complete.
Parent Name Parent Name First Last
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

Undergraduate Aid Review for Loss of Income 2024-25 Academic Year

Undergraduate Aid Review for Loss of Income 2024-25 Academic Year

2024-25 Academic Year Aid Review for Loss of Income: Type of Situation

Divorce/Separation

Medical Expenses

Loss of Untaxed Income

Projected Parent Income 2023 and 2024

Certification and Signature