Semester Response Form

Please provide the address, city, state, zip code, and phone number of the authorized parent/agency/sponsor below:

Notice:

• To cancel authorization at any time, contact Student Financial Services in writing.
• You are responsible to pay any balance due on your account that is not covered by financial aid, or that is the result of a change in your enrollment or eligibility for aid.
• To accept a student loan offer, complete and submit a loan application to Student Financial Services.

**Notice:
You will need to waive/accept your Student Health Insurance charge by creating an account and logging into Gallagher Student

Your printed first and last name and Student ID will serve as your electronic signature for the purposes of the releases above.