Bartlett Center, 100 Institute Road, Worcester MA 01609
Phone: (508) 831-5469 Fax: (508) 831-5039
Dependency Override Request Form
This form should be used by undergraduate dependent students who have an unusual
circumstance preventing them from including their parent(s) on their FAFSA/CSS Profile and are
requesting to be considered for independent student status. For more information about
unusual circumstances that may be eligible for a dependency override, please visit our website.
Student Name: _________________________________________________________________
WPI ID: ____________________________________ Class of: __________________________
Student Email: _________________________________________________________________
Personal Statement
Using the box below, please explain the unusual circumstance preventing you from including
your parent(s) on your FAFSA/CSS Profile.
Please submit this form to finaid@wpi.edu.
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Documentation
In addition to your personal statement, you must submit any two of the following:
• Letter from a third party on official letterhead confirming your unusual circumstance
o Examples of acceptable third-party individuals include a counselor, clergy
member, high school official, professor, or another third-party source familiar
with your situation in a professional capacity. Letters from family members or
friends will not fulfill the requirement.
• Copy of a court order or official federal or state documentation that your parents or
legal guardians are incarcerated
• Written statement from a state, county, or tribal welfare agency
• Written statement from a public or private agency, facility, or program servicing victims
of abuse, neglect, assault, or violence
• Written statement from an attorney, guardian ad litem, a court-appointed special
advocate
• Utility bills, health insurance, or other documents that demonstrate a separation from
parents or legal guardians
Next Steps
Please submit this form with all required documentation via email to finaid@wpi.edu or fax to
(508) 831-5039. WPI’s Office of Financial Aid will review your dependency override request
within a few weeks and may reach out to you requesting additional information. Submission of
a dependency override request is not a guarantee that it will be granted. An approved
dependency override request may or may not result in more or different types of financial aid
awarded to you. If a dependency override is made, your status as an independent student will
carry forward to subsequent years at WPI unless you inform the Office of Financial Aid that
your situation has changed again.
Certification and Signature
I hereby swear that my responses on this form are true and complete to the best of my
knowledge.
_________________________________________ ___________________________
Student Signature Date
