Fillable 1920 Student Data Sheet 1 (Northwest State Community College)

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1920 Student Data Sheet 1 (Northwest State Community College)

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The 1920 Student Data Sheet 1 (Northwest State Community College) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for Northwest State Community College

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2019-2020 Student Data Sheet
Make sure to complete both sides
Student Name: ___________________________________ NSCC ID number: N________________________
Address: ___________________________________________ Home Phone Number: (_____)_________________
City: _________________ State: _____ Zip Code: ____________ Cell Phone Number: (_____)_______________
Date of Birth: _____/_____/_____ NSCC Email Address: _____________________@students.northweststate.edu
Please check ALL semesters in which you plan on attending NSCC:
Summer 2019 Fall 2019 Spring 2020
Please check the campus location you plan on attending:
Archbold Scott Park, Toledo All online courses
Vantage Career Center Penta Career Center JATC Site: ________________
(Location)
I am working toward the completion of ONE of the following:
Associates Degree Name of major: ____________________________________________
Certificate Name of certificate: _________________________________________
I am NOT seeking a degree at NSCC ** Please note - students who are not seeking a degree or certificate are NOT eligible for
financial aid**
I plan on graduating from NSCC at the end of the following semester:
Summer 2019 Fall 2019 Spring 2020 Future Semester
I have completed ONE of the following:
High School Diploma Name of High School: _______________________________ Grad Year:_______
Homeschooled Homeschool Graduation Year:_________________________________________
GED certificate State Issued:______________ Date GED completed: _______________________
None of the above ** Please note - students who do not have a high school diploma, homeschool completion or GED are NOT eligible
for financial aid**
Expected resources, other than federal financial aid, available to meet expenses during the term(s) financial aid is desired. If you
do not know the exact amount, but know that the agency will be covering tuition, fees and books, simply write in “TFB”. Note:
All students must complete this section with the best estimates possible. If you will not receive additional resources please
leave this section blank.
Description of Resource
Summer 2019
Fall 2019
Spring 2020
Scholarships (Source): ________________________________
$___________
$___________
$___________
Agency/Company (Name): _____________________________
$___________
$___________
$___________
Other Benefits (Source): _______________________________
$___________
$___________
$___________
Student Information
Academic Plans
Resources
Northwest State Community College • 22600 State Route 34 • Archbold • OH • 43502
Phone: 419-267-1333 • Fax 419-267-5587 • finaid@northweststate.edu
Have you attended or do you plan to attend any other college(s) between July 1, 2019 and June 30, 2020?
____Yes ____No
If yes, list the institution name, city and state below.
NAME OF INSTITUTION
CITY, STATE
Federal student financial aid can only cover “institutional charges” as defined by the US Department of Education.
This definition includes current year charges for tuition and fees. Unless authorization is received, federal financial
aid cannot be used to cover non-institutional charges. (For example: books in the bookstore, educational supplies, lab
fees, and other student fees)
I authorize Northwest State Community College to apply federal student financial aid for any non-institutional
charges on your account.
I understand that this authorization will remain in effect until I submit a written request to cancel this authorization.
Please INITIAL one of the following:
Yes, I authorize ________ No, I do not authorize ________
Federal student financial aid can only cover the “current” academic year institutional charges. Current year charges
include Summer 2019, Fall 2019, and Spring 2020. To use the current academic year’s financial aid to pay for prior
year charges, you must provide written authorization. Federal regulations allow up to $200 of a prior year’s charges to
be paid by your current year’s financial aid.
I authorize Northwest State Community College to apply my federal student financial aid to pay up to $200 of
any prior year charges if applicable.
I understand that this authorization will remain in effect until I submit a written request to cancel this authorization.
Please INITIAL one of the following:
Yes, I authorize ________ No, I do not authorize ________
By signing this form, I certify that all the information reported to qualify for Federal and State student aid is complete and
correct. WARNING: IF you purposely give false or misleading information on this form, you may be subject to fines and/or
penalties.
Student Signature: _______________________________ Date: ______________________
Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age
in its programs or activities.
Other College/University Attendance
Authorization Release of Non-Institutional Charges
Authorization to Apply Federal Financial Aid to Prior-Year Charges
Student Authorization
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1920 Student Data Sheet 1 (Northwest State Community College)

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Completed 3 October 2020

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