ACI Student Survey

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 1 of 7

NOTE: If you completed a Brightwood College - Baltimore, Beltsville, or Towson

(BC-BBT) program prior to December 7, 2018, DO NOT COMPLETE THIS

FORM. To request a copy of your transcript, complete the MHEC Transcript

Request Form found under “How to Request a Transcript for a Closed Maryland

Postsecondary School” at:

https://mhec.maryland.gov/institutions_training/Pages/career/pcs/closures.aspx

The following instructions are only for students who were enrolled in Brightwood College

- Baltimore, Beltsville, or Towson (BC-BBT) at the time of closure on December 7, 2018,

or who were on approved leaves of absence as of December 7, 2018. The form also may

be used by a former BC-BBT student who withdrew from, or was withdrawn by, BC-

BBT if the student did not receive a refund that was required (if any) under the student’s

enrollment agreement with BC-BBT. If you are uncertain whether to complete this form,

please contact MHEC.

INSTRUCTIONS:

1. Review the options listed on the next page titled “Options for Students Affected by an Institution’s

Closure” on the next page.

2. Complete sections:

A. Contact Information

B. Institution Location, Enrollment Status, and Program Information

C. Claim Options

D. Method and Amount of Payment to Brightwood (only for those seeking a state refund)

E. Authorization to Release Information

CONSIDER YOUR OPTIONS CAREFULLY BEFORE COMPLETING THIS FORM. By checking

one of the four options, you affirm that you have read and understand the information regarding

your options, and that you are not pursuing a different option.

3. This completed form must include the requested documents and must be signed. You may email

all documents to [email protected] or mail to:

ATTN: First Report of Claim Form – BC-BBT

Maryland Higher Education Commission

BC-BBT First Report of Claim Form

6 N. Liberty Street, 10

th

Floor

Baltimore, MD 21201

Please do not submit your documents more than once.

4. If there are any changes in name, mailing address, email address, or phone number after you have

submitted this form, it is your responsibility to inform MHEC immediately.

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 2 of 7

Options for Students Affected by an Institution’s Closure

Students affected by the closure of one of the Brightwood campuses in Maryland have 4 different options.

Please review them carefully. You may select only one option.

1. Pursue a federal loan discharge (if applicable) AND a state refund of all self-paid and/or private

lender monies paid to the school.

If you opt for a state refund of tuition and fees that were self-paid by you and/or were paid by a private lender on

your behalf, then you may not pursue options #2, #3, or #4 below. In other words, you will not be able to

“transfer” any Brightwood coursework to another institution or apprenticeship, or to receive a teach-out. (If you

passed a certification exam, then that is between you and the certifier. It is not addressed here.)

By choosing this option #1, you will also have to separately apply to the U.S. Department of Education for a

federal student loan discharge, if applicable. While MHEC cannot speak for the federal government, please note

that the U.S. Department of Education generally will NOT allow you to have your federal loans forgiven AND

to transfer your Brightwood credits to another institution. You will have to choose one or the other.

Additional documentation will need to be submitted if you proceed with this route, such as payment history,

enrollment agreements, and academic records (please see section E for more information).

2. Pursue a teach-out opportunity at a state-approved teach-out school.

If you choose to participate in an approved teach-out institution you must first contact the approved institution.

You will not receive a state refund for any federal or private loans taken out to fund your Brightwood program,

or for any tuition and fees you self-paid to Brightwood. Please visit the MHEC website

to view a list of

institutions that have committed to accepting Brightwood credits.

3. Pursue an approved Registered Apprenticeship program in your field of study at Brightwood.

If you choose to continue your career path in an approved Maryland Registered Apprenticeship program that

aligns with your field of study at Brightwood, you will need to contact info@mdapprenticeship.com

. You will

not receive a state refund for any federal or private loans taken out to fund your Brightwood program, or for any

tuition and fees you self-paid to Brightwood.

4. Pursue a self-chosen/determined transfer to another school.

Students pursuing this option will be subject to all transfer policies of the accepting school. You will not receive

a state refund for any federal or private loans taken out to fund your Brightwood program, or for any tuition and

fees you self-paid to Brightwood.

I have reviewed this information and understand that if I transfer my Brightwood academic credits either

through a teach-out, transfer, or an apprenticeship program, I cannot pursue a state refund of tuition and fees

paid to Brightwood. I also understand that if I choose to pursue a state refund , I cannot transfer my Brightwood

academic credits to another institution.

I affirm that I am over the age of 18 and competent to complete this form, and that the information provided in

this form is correct, complete, and accurate to the best of my knowledge.

Printed Full Name:

Signature: Date:

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 3 of 7

SECTION A: Contact Information

Full Name (at time of enrollment):

Current Name (if different at time of enrollment):

Date of Birth (month/day/ year): Social Security #:

Current Home Address:

City: State: Zip:

Current Mailing Address (if different from home address):

City: State: Zip:

Telephone #: (Primary) (Secondary)

Current E-Mail Address:

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 4 of 7

SECTION B: Institutional Location, Enrollment Status, and Program Information

Please identify the Brightwood College – BBT campus in which you were enrolled:

1520 South Caton Avenue, Baltimore

4600 Powder Mill Road, Beltsville

803 Glen Eagles Court, Towson

Please check your enrollment status at the time Brightwood College - BBT closed on December 7,

2018 (check one):

I was attending Brightwood College - BBT when it closed.

I never started classes. I enrolled and made a partial or full payment, but never started any

classes at Brightwood College -BBT.

I completed all of my coursework for my academic program before Brightwood College -

BBT closed.

I had already withdrawn from Brightwood College - BBT at the time it closed.

I was terminated by Brightwood College - BBT before the school closed

I was enrolled and began my courses, but was on a Leave of Absence at the time

Brightwood College - BBT closed

Other (please specify)

Name of the academic program in which you were enrolled:

Degree level of the Brightwood College - BBT program in which you were enrolled: (example: Lower

Division Certificate or Associate Degree):

When did you first enroll at Brightwood?

When were you scheduled to complete your entire program of study (i.e., when did you expect to

graduate)?

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 5 of 7

SECTION C: Claim Options (choose ONE)

OPTION 1: FEDERAL LOAN DISCHARGE AND STATE REFUND

I want a state refund of all private loans and self-paid tuition and fees, and I will pursue a federal student loan

discharge from the U.S. Department of Education (if applicable). I will not be participating in a teach-out,

registered apprenticeship, or transferring to another institution for completion of this program.

I understand that if I choose this option, I will complete Section D of this form.

OPTION 2: STATE ORCHESTRATED TEACH-OUT

I will be pursuing a teach-out at an institution identified by MHEC to complete my program. I understand that I

will not receive a state refund for tuition and fees paid by me or on my behalf to Brightwood.

OPTION 3: MARYLAND REGISTERED APPRENTICESHIP

I will be pursuing a Maryland Registered Apprenticeship opportunity in the field I had studied at Brightwood. I

understand that I will not receive a state refund for tuition and fees paid by me or on my behalf to Brightwood.

OPTION 4: TRANSFER

I will independently pursue transferring into another institution’s program to complete my education. I

understand that I will not receive a state refund for tuition and fees paid by me or on my behalf to Brightwood.

I have chosen option and understand I cannot pursue a different option.

I affirm that I am over the age of 18, competent to complete this form and determine which option to

pursue, and that the information provided in this form is correct, complete, and accurate to the best of

my knowledge.

Printed Full Name:

Signature: Date:

If you have chosen option 2, 3, or 4, you can request your academic transcript by completing the information

below.

Please send a copy of my official transcript to:

The following school:

Address:

My home address:

Number of copies requested:

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 6 of 7

SECTION D: Method and Amount of Payment to Brightwood College-BBT

TO BE COMPLETED ONLY IF YOU ARE PURSUING A OPTION #1: STATE REFUND

For a state refund, please check the method of payment and write in the amount paid by you or on your behalf to

Brightwood College-BBT. These amounts should reflect what was actually paid, not the amount promised to be

paid.

Method of Payment

Paid to (if applicable)

Amount

Credit Card $

Cashier’s Check, Money Order, or Cash $

Total Federal Financial Aid paid on your behalf* $

Private Student Loan paid on your behalf $

Other loan (please specify) $

Other (please specify) $

Supporting documentation of payment is critical. You must enclose copies of any proof of payment,

such as canceled checks, charge card statements, money order receipts, or school receipts. These

documents should include, at a minimum:

− Loan agreement papers with any lending institutions, including those for federal financial aid

− Proof of personal payment(s) to Brightwood College - Baltimore, Beltsville, Towson

− Proof of payment on your behalf from a private lending institution(s)

In general, you cannot obtain a state refund for federal student loans that can be discharged through the

federal government for a “closed school discharge.” If you have been denied a discharge by the

federal government and are seeking a state refund of those amounts, you first must obtain and enclose

a final decision for your federal student loan discharge from the U.S. Department of Education

.

MHEC may ask for additional documentation in order to process this request. MHEC also may obtain

your transcript and account information directly from Education Corporation of America, Brightwood

College, the U.S. Department of Education, or your private lender(s).

I affirm that I am over the age of 18 and competent to complete this form, and that the information

provided in this form is correct, complete, and accurate to the best of my knowledge.

I have enclosed copies of any proof of self-payment (e.g., receipts) and any loan information (e.g.,

loan statements).

Print Full Name:

Signature: Date:

MARYLAND HIGHER EDUCATION COMMISSION

FIRST REPORT OF CLAIM FORM

BRIGHTWOOD COLLEGE - BALTIMORE, BELTSVILLE, and TOWSON CLOSURE

FRC – Brightwood-BBT

Form last updated: Jan 17, 2019

Page 7 of 7

SECTION E: Authorization to Release Information

I affirm that I am over the age of 18 and competent to complete this form, and that the information

provided in this form is correct, complete, and accurate to the best of my knowledge.

I understand and agree that information provided in this form and any supporting documentation,

including my personal educational records and my financial information, may be provided between

MHEC, other government agencies, lenders, insurers, financial institutions, and educational

institutions solely for the purpose of investigating and processing my claim. The information will be

protected and shared in a manner consistent with applicable law. My consent to share personally

identifiable information, as described above, terminates once this claim has been fully determined and

processed.

Print Full Name:

Signature: Date: