M
ail, fax, email, or deliver the completed worksheet to the financial aid office using the contact information listed below.
EMAILED FORMS MUST BE SENT FROM THE IWU STUDENT EMAI
L ACCOUNT
Financial Aid Office, IWU National & Global 1900 West 50
th
Street Marion, IN 46953-9393 indwes.edu
800.621.8667 option 4 765.677.2516 765.677.2030 Fax IWUfinaid@indwes.edu
FINANCIAL AID OFFICE
UNACCOMPANIED HOMELESS
YOUTH DETERMINATION FORM
You may wish to refer to the Appeal for Dependency Override form if your situation is different than those indicated below. This
form should be completed if:
You are 23 years of age or younger, and
You answered “no” to all other dependency status questions on the 2019-2020 FAFSA, and
You do not have and cannot get documentation showing the determination by a school district homeless liaison, director
of a HUD-funded emergency shelter or transitional housing program, or director of runaway or homeless youth basic
center or transitional living program that after July 1, 2018 you were an unaccompanied homeless (or self-supporting and
at risk of being homeless) youth.
• If you have a copy of the determination, please review the last three dependency status questions in Step 3
on the FAFSA and make a correction to one of them, if appropriate.
Definitions
H
omeless Youth Definitions
At risk of being homeless—when a student’s housing may cease to be fixed, regular, and adequate (e.g., a student who
is being evicted and has been unable to find fixed, regular, and adequate housing).
Homeless—lacking fixed, regular, and adequate housing.
Self-supporting—when a student pays for his or her own living expenses, including fixed, regular, and adequate housing.
Unaccompanied—when a student is not living in the physical custody of a parent or guardian.
Youth—a student who is 21 years old or younger or still enrolled in high school as of the date of signing the FAFSA.
Housing Definitions
Fixed—stationary, permanent, and not subject to change.
Regular—used on a predictable, routine, or consistent basis.
Adequate—sufficient for meeting both the physical and psychological needs typically met in the home.
Student Identification
_______________________________________ ____ ______________________________________________
First Name M.I. Last Name
__________________ OR __________________ _____________________________
Student ID Last 4 Digits of SSN Phone Number
Basis for Consideration (Check One)
I am 23 years old or younger and am unaccompanied and homeless
I am 23 years old or younger and am unaccompanied, self-supporting, and at risk of being homeless
Required Documentation: You must submit two (2) letters detailing your circumstances. These letters must provide enough
detailed information for our office to make an informed determination of your circumstance and also must include contact
information from the individuals writing the letters.
o A letter from you, the student, detailing your situation.
o A letter from a person who knows and understands your, the student’s, situation—preferably someone with whom the
student at some point has found temporary housing—explaining the circumstances and indicating that person’s
association to you, the student.
We understand that your situation is personal, and we hold your information in the highest confidentiality. Only authorized
financial aid personnel or others deemed necessary by law have access to your information.
Certification and Signature: I certify the information provided is complete and true to the best of my knowledge. I understand
that changes made to my student financial aid eligibility based upon the information provided may affect only the student financial
aid received at Indiana Wesleyan University for the 2019-2020 award year.
_______________________________________________________________________ ______________________
Student Signature* Date
* Must be an actual “wet” signature. A digital signature or typed font signature is not acceptable. This form may be completed and “wet” signed via a tablet
or smartphone with PDF signing capability using a stylus pen. You may need to download an app to access this feature.
IMPORTANT: Indiana Wesleyan University’s Financial Aid Office will honor special circumstances documentation submissions made no later than two
weeks prior to when the student ceases attendance for the applicable award year. We cannot guarantee a review of submissions made after this date,
and no consideration will be given to submissions made after the student ceases to attend.
(
