Educational Grant Certification

EDUCATIONAL GRANT CERTIFICATION

Recipient Information

Date of Birth:     Student ID:

Grade Level / Classification:     Expected Credits This Term:

Grant Award Details

Award Amount:     Award Period Start:     End:

Tuition     Mandatory Fees     Room & Board     Books / Supplies     Other

Eligibility and Certifications

By checking each box below and signing this form I certify, under penalty of law, that the information provided is true and correct and that I understand the obligations set forth in this certification.

I am enrolled or will be enrolled at the institution for the period specified above and will provide proof of enrollment if requested.

I meet the academic and progress standards required for receipt of this grant, including Satisfactory Academic Progress where applicable.

I will use grant funds only for allowable educational expenses and will not divert awarded funds for unauthorized personal use.

I certify that I am not receiving other grants, scholarships, or benefits that duplicate payment for the same institutional charges without appropriate offsets and notification to the grantor.

I understand that if I knowingly provide false or misleading information, or if I fail to meet eligibility requirements, the grantor or institution may reduce or demand repayment of funds, set off future disbursements, or pursue collection.

I will promptly notify the institution and the grantor in writing of any changes in enrollment status, address, financial circumstance, or other factors that affect eligibility or the amount of the award.

I authorize the release of enrollment, financial, and academic records to the grantor or auditors for purposes of verification, audit, and compliance with programmatic requirements.

Current Cumulative GPA:     Credits Enrolled This Term:

Obligations, Repayment, and Legal Notice

The recipient understands that disbursement of grant funds is conditioned upon continued eligibility. In the event of withdrawal, reduction in enrollment, or other change affecting eligibility, the recipient may be required to return funds or have funds recovered from future aid. Knowingly making a false statement or misrepresentation in connection with this certification is subject to institutional disciplinary action and may subject the recipient to civil and criminal penalties under applicable laws.

The grantor and institution reserve the right to review supporting documentation, require repayment for ineligible disbursements, and pursue all remedies available to recover funds, including referral to collection agencies or offset against other receivables.

Parent / Guardian (If Recipient Is a Minor)

Recipient is a minor; parent or guardian information and signature below will be used to certify on behalf of the minor recipient.

Relationship to Recipient:     Contact (phone or email):

Certification and Signature

I certify that the information contained in this Educational Grant Certification is complete and accurate to the best of my knowledge. I understand the responsibilities associated with acceptance of the grant and acknowledge that I may be required to provide supporting documentation to verify eligibility. I consent to disclosures reasonably necessary to administer, audit, or enforce the terms of the grant.

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