Fillable 17 18 Supplemental Financial Aid Application (Green River Community College)

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17 18 Supplemental Financial Aid Application (Green River Community College)

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12401 SE 320
th
St.
Auburn, WA 98092-3622
(253) 833-9111 ext. 2449
Fax (253) 288-3473
Finaid@greenriver.edu
Supplemental Financial Aid Application 2017-2018
(Complete and return to the Financial Aid Office)
How to Apply for Financial Aid
(1) Submit a FAFSA at www.fafsa.gov.
(2) Submit a 2017-2018 Supplemental Financial Aid Application to the Green River Financial Aid Office.
(3) Submit official transcripts for all prior colleges attended and the Transcript Evaluation Request Form to Enrollment Services.
(4) Other documents and information may be required for verification purposes. Check the Student Financial Aid Portal to see if you
need to submit additional information and documents.
(5) Applications must be complete prior to the dates listed below. Late applicants will be asked to pay for tuition and book expenses.
FINANCIAL AID PRIORITY DEADLINES 2017-2018
Fall Quarter - March 15, 2017 Winter Quarter - October 15, 2017 Spring Quarter - January 15, 2018 *Summer Quarter - April 15, 2018
* To be considered for Summer Quarter aid, please submit a Summer Request Form during Spring Quarter.
STUDENT INFORMATION
Name _____________________________________________________________________________________
Last First Middle
Social Security Number _______________________________ Student ID Number ___________________________
Previous Last Name ____________________________ Age _____ Birth date _______________ ☐ Male ☐ Female
E-mail ____________________________________________________________________________________
Where will you live while attending college during 2017-2018?
with parents ☐with spouse ☐with roommate ☐alone ☐with children ☐room provided by friend/relative ☐☐ campus apartment
Address while attending college (if you receive mail at a PO Box, you must list a street address as well as box number)
_________________________________________________________________________________________
Number Street Apt. No. City State Zip
__________________________________________________ ___________________________________
PO Box City State Zip Telephone Number
Notify The Financial Aid Office if your address changes.
RESIDENCY
In what state do you hold legal residence? ________________ How many consecutive years and months will you have lived in
Washington State immediately prior to September 1, 2017? Years _______ Months ________________
PARENTAL/EMERGENCY INFORMATION (Note: ALL Applicants Must Complete This Section)
List your parents below. If both parents are deceased or reside outside the U.S., check here ☐and list your nearest relative (other
than spouse) or other friend who would know how to locate you. Write his/her relationship to you.
Mother’s Name __________________________ Father’s Name __________________________________
Address ________________________________ Address _______________________________________
City, State, Zip ___________________________ City, State, Zip __________________________________
Telephone Number _______________________ Telephone Number ______________________________
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STUDENT ACADEMIC INFORMATION
☐ First-year student (0-44 credits) ☐ Second-year student (45-89 + credits) ☐ BAS Third/Fourth-year student (90+ credits)
Degree or Certificate You Are Pursuing at Green River College (Check Only One)
Estimate when you will complete the program selected above. Month _____________ Year ___________________
Do you currently have a college degree? Include degrees received outside of the United States.
☐Yes ☐No If yes, what type: ☐Associate-2 yr. ☐Bachelor- 4 yr. ☐Other ________________________________
Title of Degree _________________________________ Date degree was earned ___________________
Do you have a:
☐ High School Diploma Mo./Yr. graduated ________ School Name __________________ City _____________ State ________
If not in the US, Country Name ___________________________________
☐ GED/GED® Certificate Mo./Yr. received __________ School Name __________________ City _____________ State ________
If no H.S. Diploma or GED/GED®, will you be in High School Completion or Running Start during 2017-2018? ☐ Yes ☐ No
PREVIOUS EDUCATION
List all colleges or schools you have attended since high school. If you have attended none, write N/A, DO NOT LEAVE BLANK.
NOTE: Official Transcripts for all prior colleges attended must be submitted to Enrollment Services prior to aid being awarded.
Name of School Period of Attendance Credits Completed
_____________________________________________________________ ________________________________ _______________________
_____________________________________________________________ ________________________________ _______________________
_____________________________________________________________ ________________________________ _______________________
_____________________________________________________________ ________________________________ _______________________
ADDITIONAL AID
In addition to grant assistance, would you like to be considered for:
☐ Yes ☐ No Federal Work Study (not eligible if working at another job)
☐ Yes ☐ No Federal Direct Student Loan (may be required to fill out a Direct Loan Worksheet)
QUARTERS REQUESTING AID
Indicate ALL term(s) you are requesting financial aid:
☐ Fall 2017 ☐ Winter 2018 ☐ Spring 2018 ☐ Summer 2018 (Limited Funding)
Intended enrollment level:
☐ Full-time (12 or more credits), ☐ 3/4 time (9-11 credits), ☐ 1/2 time (6-8 credits), ☐ Less than 1/2 time (1-5 credits)
Career/Technical Degree
☐ Program_______________________________________
Certificate
☐ Program: _______________________________________
Bachelor’s Degree
☐ Program: _______________________________________
University Transfer Degree
☐ Associate in Arts - DTA
☐ Associate in Business - DTA
☐ Associate in Fine Arts in Art- DTA
☐ Associate in Math Education - DTA
☐ Associate in Pre-Nursing - DTA
☐ Associate in Science Degree Transfer Option 1 and 2
☐ Associate in Science Degree Transfer Option 2 Major
Related Program (MRP)
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HOUSEHOLD INFORMATION
If parents’ information is required on the FAFSA, include yourself, your parents and anyone your parents provide over 1/2 their
support, including those away at college who use your parents’ information on their FAFSA.
If parents’ information is not required on the FAFSA, include yourself, your spouse and anyone you provide over 1/2 their support.
Relationship to Student Name Age Name of School (if attending college at least ½ time)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
STUDENT’S FAMILY INFORMATION
Student’s Marital Status: ☐ Single ☐ Divorced ☐ Separated ☐ Married Date: _____________________
Number of dependent children permanently living with you: ______________________________________________________
Children’s ages: ___________________________________________________________________________________________
Student (Do not report work-study.)
Are you currently employed? ☐ Yes ☐ No
Starting date: _____________
Employer: _________________________________________
Average number of hours worked per week: _____________
Hourly pay rate: $ _______ or monthly pay rate: $_________
☐ I will continue this job. Hours per week: ______________
☐ I will terminate this job as of: _______________________
Spouse (Skip if you do not have a spouse.)
Is spouse currently employed? ☐Yes ☐ No
Starting date: _____________
Employer: ____________________________________________
Average number of hours worked per week: ________________
Hourly pay rate: $ _______ or monthly pay rate: $ ____________
☐ Spouse will continue this job. Hours per week: ____________
☐ Spouse will terminate this job as of: _____________________
STUDENT’S OTHER RESOURCES FROM JULY 2017 TO AUGUST 2018
$ Monthly $ Monthly
Social Security/SSI ……………………. __________________ Unemployment Compensation ………….. __________________
Labor & Industries (L&I) …………… __________________ Worker Retraining/TAA ……………………… __________________
Child Support …………………………… __________________ DVR/Vocational Rehabilitation …………… __________________
Spousal Maintenance ……………… __________________ Veterans Non-education Benefits ……… __________________
Public Assistance (TANF/GAU)…. __________________ Tribal Funds ……………………………………... __________________
Assistance from Parents/Others __________________ Scholarships ……………………………………… __________________
NOTE: If you reported no income or resources, how are your living expenses covered? ________________________________
________________________________________________________________________________________________
STUDENT’S RELEASE OF CONFIDENTIAL INFORMATION
Please list the name and the relationship of anyone you would like to be able to discuss your file with the Financial Aid Office:
Name______________________________________________ Relationship_______________________________________
Name______________________________________________ Relationship_______________________________________
Self
Green River College
CERTIFICATION AND CONDITIONS OF AWARD
Must print and sign before submitting. Forms without signatures will be disregarded.
I understand that:
• I must enroll in a program of study that leads to an approved degree or certificate at Green River College and the classes I take
must be required for that program. I cannot use financial aid for high school completion, Adult Basic Education, Continuin
g
Ed
ucation or English for Speakers of Other Languages classes.
• I must maintain satisfactory academic progress in order to obtain and continue financial aid funding. This policy is explained in
de
tail in a separate brochure and on the Financial Aid website.
• I can be considered for financial aid eligibility during the equivalent of my first nine full-time quarters of attempted credits o
f
100 l
evel or higher (150% program time). This period includes transfer credits. Program changes can result in the immediate
loss of eligibility if the program cannot be completed in the allowed financial aid timeframe. Students enrolled in a Bachelor’s
degree are eligible for additional quarters of aid.
• I am responsible for repaying all or part of my grants as well as any federal tuition refund in excess of the college’s own ref
und
policy should I withdraw or stop attending classes during the quarter. Students who default on any financial obligations to
Green River College are responsible for collection agency fees, attorney fees, court fees, and other reasonable costs and
expenses incurred in the collection of any debt, in accordance with RCW 28B.10.293 and RCW 19.16.500.
• If awarded Federal Work-Study, a job is not guaranteed. After an orientation session, I will be placed on payroll at the time I
submit my last required form if a space on the payroll remains available.
• I must agree to use state or federal financial aid funds for educational expenses related to my attendance at Green River
College (tuition and fees, books and supplies, room and board, personal expenses, child care and transportation - excluding
t
he purchase of a car).
• To be eligible for financial aid, I must not owe a refund or repayment on a state or federal grant and not be in default on a
student loan.
• Green River College reserves the right to adjust your financial aid because of changes in state or federal funding. A financial
aid award does not imply a commitment on the part of the college to continue assistance beyond the time period stated in the
award.
• I will notify the Financial Aid Office of any changes in name, address or marital status, or the receipt of agency funding or other
scholarships outside of the college.
• I must reapply for financial aid each year and adhere to the annual application deadlines.
• To receive a Washington State Need Grant, I must (a) be a resident of Washington State in accordance with RCW
28B.15.012(2) (a) through (d).; (b) be registered for 3 or more credits; (c) be making satisfactory progress toward my degree or
certificate (not in theology); (d) not owe a refund or repayment on a state or federal grant; (e) and not be in default on
a
s
tudent loan. You can make voluntary future contributions to the Higher Education Coordinating Board in recognition of the
State Need Grant to be used to provide assistance to other students.
• If I deliberately falsify, misrepresent or fail to fully disclose information on my financial aid application, I can be terminated
from all financial aid for a year. If I receive funds based on misrepresented information, I will be required to repay the funds
and may be reported to the U.S. Department of Education Investigation Division for possible fraud.
Must print and sign before submitting. Forms without signatures will be disregarded.
I affirm that the information contained on my financial aid applications is true and correct to the best of my knowledge.
My signature indicates that I have read and agree to the Certifications and Conditions of Award.
Signature ________________________________________________________ Date _____________________________
Additional information and/or forms may be required when we receive your processed FAFSA.
Check the Student Financial Aid Portal on Green River’s financial aid website to see if all forms have been submitted.
SUBMIT COMPLETED FORM TO THE GREEN RIVER FINANCIAL AID OFFICE
12401 SE 320th St. Auburn, WA 98092-3622
Phone: 253.833.9111 ext. 2449
Fax: (253) 288-3473
Finaid@greenriver.edu
Financial aid programs at Green River are administered according to Federal policies, based on the belief that parents have the primary responsibility for assisting
their children with educational expenses. Green River College does not discriminate on the basis of race, creed, color, national origin, gender, gender orientation, age,
marital status, religion, disability, genetic information or on any other unlawful basis. The college is committed to preventing and stopping discrimination, including
harassment of any kind and any associated retaliatory behavior. The following person has been designated to handle inquiries regarding the non-discrimination
policies: Vice President of Human Resources, 12401 SE 320th Street, Auburn, WA 98092-3622, (253) 288-3320. To receive this information in an alternate format,
please contact Disability Support Services at (253) 833-9111, ext. 2631; TTY (253) 288-3359.
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17 18 Supplemental Financial Aid Application (Green River Community College)

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Completed 27 July 2020

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