F&M College Plus Loan Refund Release Form
Student Information
Name:________________________________
F&M ID Number:______________________
Parent (Borrower) Information
Name:________________________________
Address:______________________________
City:_________________________________
State/Zip:_____________________________
E-Mail:______________________________
Telephone:___________________________
______________ Refund to the Student
______________ Refund to the Parent (Borrower) at above address
_______________________________ _______________
Borrower's Signature Date
