Education Financial Aid Application

EDUCATION FINANCIAL AID APPLICATION

Use this application to request institutional financial assistance for the academic term indicated. Complete all sections fully and attach required documentation. Deliberate falsification or omission of material information may result in denial of aid, rescission of awards, or requirement to repay funds received.

Student Information

Date of Birth:    Student ID:

Phone:    Email:

U.S. Citizen    Permanent Resident    Other (specify below)

Parent / Guardian Information (if student is a minor)

Is the applicant 18 years of age or older?    Yes    No

Relationship:    Phone:

Household Financial Information

Wages/Salary    Public Assistance    Unemployment Benefits
Commissions / Self-Employment    Other

Requested Aid and Enrollment

One-time disbursement    Installments (specify schedule below)

Documentation Checklist

Please include copies of the following with this application (check all included):
Proof of income (pay stubs, employer letter, or benefit statement)
Most recent tax return (if available)
Current academic transcript
Letter of acceptance / enrollment verification
Recent bank statements
Additional documentation (explain below)

Certifications, Authorizations, and Institutional Terms

By signing below I certify under penalty of perjury that the information supplied in this application and in any attached documents is true, complete and correct to the best of my knowledge. I understand that the institution may verify information submitted and may request additional documentation. I authorize release of information from employers, financial institutions, government agencies, and other educational institutions for the purpose of determining eligibility for institutional aid.

I acknowledge that any financial aid award is subject to enrollment verification, continued compliance with academic and conduct requirements, and availability of institutional funds. I agree to notify the institution immediately of any significant change in financial circumstances or other factors that may affect eligibility. I understand that knowingly making false statements or submitting falsified documents may result in rescission of awards, requirement to repay funds, disciplinary action, and possible referral for criminal prosecution.

I further understand that awards may be reduced or rescinded if other sources of funding are subsequently identified. The institution's decisions on awards and disbursements are administratively final unless an appeal is submitted in accordance with institutional appeal procedures.

Email    Phone    Postal Mail

Privacy and Non-Discrimination Statement

Information provided on this form will be used solely for the administration of institutional financial assistance and related recordkeeping. Access to applicant records will be limited to institutional staff with a legitimate educational interest. The institution provides financial assistance without regard to race, color, national origin, sex, disability, or age, in accordance with applicable law.

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