Fillable 1718 UEH (De Anza College)

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1718 UEH (De Anza College)

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FOOTHILL COLLEGE DE ANZA COLLEGE
FINANCIAL AID OFFICE FINANCIAL AID OFFICE
12345 El Monte Rd. 21250 Stevens Creek Blvd.
Los Altos Hills, CA 94022-4599 Cupertino, CA 95014-5793
2017-2018
Unusual Enrollment History Verification
Student’s Name: ______________________________________________ SID:____________________
Last First (Student ID#)
Preferred Name (if different than above) _______________________________________________
Last First
The U.S. Department of Education (DOE) is concerned that you have an Unusual Enrollment History (UEH). UEH
means the student might be attending an institution just long enough to receive (Title IV) federal student aid funds, leaves
without completing the enrollment period, enrolls at another institution, and repeats the pattern of attending just long
enough to collect Title IV funds without having earned any academic credits. This form will determine your eligibility for
additional Title IV funds.
Please list below all institutions/universities attended during award years 2013-2014, 2014-2015, 2015-2016, and 2016-
2017. Please attach all academic transcripts (unofficial or official) for all institutions listed. If your only enrollment was
at Foothill or De Anza Colleges, check with the Financial Aid Office to determine whether or not you need to complete
this step.
College or University
Name
Enrollment Period
(Semester, Quarter)
Number of
Units/Credits
Attempted/Enrolled
Number of
Units/Credits
Completed/Earned
Example: ABC College
Fall 2014
12
0
Certification and Signature
I certify that all of the information reported is complete and correct. I know that if I purposely give false or misleading
information on this worksheet, I may be prosecuted with the outcome being fines and/or jail time.
_____________________________________________________ ___________________
Student’s Signature Date
4/03/17
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1718 UEH (De Anza College)

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Completed 19 July 2020

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