University of Wisconsin - Green Bay, "Connecting learning to life."
Home Search Departments University of Wisconsin - Green Bay UW-Green Bay PhoenixBursar's Office

Appeal of Institutional Charges

Note: It is assumed that you are aware of the tuition fee schedules, late payment penalties, refund schedules, and deadlines. This information is located on the Bursar’s website. If there are questions about the accuracy of any terms or if you are seeking payment arrangements see the Student Billing Office, Room SS1300, before completing this form. If you wish to file an appeal, complete the following:

First Name: Last Name:

Campus ID: Campus Email: Daytime Phone:

Current Mailing Address:

Semester for Appeal (e.g. Spring 2011):

For Housing Damage Charges use the Resident Life Appeal Form.

For Course fee appeals contact the Academic Department.

Charges being Appealed: All Charges Late Fee Tuition/Seg Fees

Math Testing Fee Clicker Fee Focus Fee

Other charges (Specify):

Explanation: Please give detail of the charges being appealed and reason for appeal. Be sure to include all appropriate dates in sequence.

Please check here if you will be sending additional documentation.

Please send any supporting documentation to the Student Billing Office SS1300, 2420 Nicolet Dr., Green Bay, WI 54311-7001 or email bursar@uwgb.edu. Medical appeals require additional documentation from a physician. If additional documentation is not received within 2 weeks of appeal submission date, the appeal will be decided based upon information provided.