Fill - Free fillable 2010-11 March2GPA Form PDF form

Cal Grant GPA Verication Form

For 2010-11 Academic Year

TO BE FILLED OUT BY STUDENT

Please print clearly using black ink only.

1. Your Social Security number: 2. Month/year of

high school

Re-enter your Social Security graduation (If currrently a HS senior, anticipated date)

number: (REQUIRED)

3. Your name — last, rst, middle initial, as it is listed on your Social Security card and FAFSA:

Your Last Name Your First Name M.I.

4. Your date of birth: 5. Telephone number:

Month Day Year Area Code Phone Number

6. Your permanent mailing address:

Number and Street

City State Zip Code

7. Your E-mail address, if available: CSAC USE ONLY

8. Spring school code: If enrolled for spring 2010, enter your school code.

9. Fill in bubble if you are submitting a SAT, ACT or GED test score instead of a GPA.

Attach your applicable test score to this form, transcripts will not be accepted. You do not have to have your school ll out the FOR SCHOOL USE ONLY section

10. STUDENT CERTIFICATION: I have read the instructions and information accompanying this form. I understand that this Cal Grant GPA

Verication Form is used to determine Cal Grant eligibility and the GPA must be calculated as described on the attached GPA Calcula-

tion Instruction sheet. The information I have completed is true to the best of my knowledge, and I understand that it is illegal to report

false or misleading information. I understand that without a valid Social Security number and signature, this form will not be considered.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

_____________________________________________________________ ________________________________________

Student Signature Date

FOR SCHOOL USE ONLY (High schools MUST be fully accredited by the Western Association of Schools and Colleges [WASC] or an

equivalent regional accreditation agency to certify a Cal Grant high school GPA)

GPA IS BASED ON HIGH SCHOOL COURSEWORK? GPA VERIFIER’S SCHOOL CODE:

CALIFORNIA COMMUNITY COLLEGE REESTABLISHED GPA?

The signature of the high school or college ocial certies, under penalty of perjury, that the GPA is calculated as described on the attached GPA

Calculation Instruction sheet. The signature of a high school ocial also certies that his or her high school is fully accredited by the WASC or other

regional accrediting agency, or has a UC-approved course list as required by California regulations. I declare under penalty of perjury under the

laws of the State of California that the foregoing is true and correct.

_____________________________________________________________ ________________________________________________

Signature of School Ocial Name of School

_____________________________________________________________ ________________________________________________

Title of School Ocial Street Address of School

_____________________________________________________________ ________________________________________________

Date E-mail Address City State Zip Code

Mail completed form to: California Student Aid Commission, Cal Grant Operations, P.O. Box 419077, Rancho Cordova, CA 95741-9077

DEADLINE: MARCH 2, 2010

DO NOT SEND ACADEMIC TRANSCRIPTS

SEE BACK OF FORM FOR INSTRUCTIONS

REGIONAL ACCREDITATION AGENCY (HS ONLY) __________________

GPA CANNOT

BE ABOVE 4.00

VERIFIED STUDENT GPA:

Instructions for lling out the Cal Grant GPA Verication Form

STUDENT INFORMATION SECTION. Please print clearly using black ink only. Filing deadline for 2010-11 awards is March 2, 2010

1. Your Social Security number: Enter your Social Security number (SSN) as it appears on your Social Security card and your FAFSA. (Valid SSNs

do not begin with 8, 9 or 000. If you believe your SSN begins with an 8, 9 or 000, then contact your local Social Security Oce to verify your

number.) Individual Tax Identication Numbers (ITIN) are not accepted.

2. Month/year of high school graduation: Enter the month and year you graduated, or plan to graduate from high school. Enter the month in a

two-digit format (for example: January should be appear as “01”; November should appear as “11”). Enter the year in a four-digit format (for

example: 2010 should appear as “2010”).

3. Your name: Print your full name as it appears on your Social Security card. Enter last name, rst name, middle initial.

4. Your date of birth: Enter your birth date. For example, June 25, 1992 would be entered as 06-25-1992.

5. Telephone number: Enter your area code and daytime telephone number.

6. Your permanent mailing address: Enter your permanent mailing address, city, state and ve-digit zip code.

7. Your E-mail address: Enter an E-mail address where you can be contacted for questions. This is optional.

8. Spring school code: Enter the school code for the school at which you were in attendance for spring 2010. Students graduating from high

school in spring 2010 should write in the College Board high school code number for their high school. This is the same code used for send-

ing SAT score information to the high school. Students who will be in college for the spring 2010 school term should write in the federal

code number of the college you are attending in spring 2010. Students who are not in college or high school for the spring 2010 school term

should leave this section blank.

9. Submitting a test score instead of a GPA: Complete questions 1 through 10, sign the form and attach a photo copy of the testing organization’s

score report and mail by the deadline to Commission. TRANSCRIPTS ARE NOT ACCEPTED.

The results from the GED, SAT or ACT tests must be submitted in lieu of a GPA if:

n You participated in a home schooling program or attended an unaccredited high school.

n You attended a high school or college outside of the United States and are unable to have those grades converted to a 4.00 scale or your

school did not grade in a manner that can be readily converted to a 4.00 scale.

n Students who have been out of school for ve years can choose to submit either test scores or submit their GPA.

– Scores from the California High School Prociency Examination (CHSPE) cannot be accepted in lieu of a high school GPA, but passing

the CHSPE does meet the high school graduation requirement of the Entitlement Cal Grant program. Also, grade reports, transcripts,

and other prociency certicates WILL NOT BE ACCEPTED.

10. Student signature: By signing this form, you certify that you have read these instructions and that the information you provided is correct. It is

illegal to report false or misleading information on this form and doing so may result in any Cal Grant award being revoked.

Once you have lled out the student information, take the form to your school and request that they verify your GPA. Be aware that if your

school will be electronically submitting your GPA to the California Student Aid Commission, you do not need to submit this form. It is your

responsibility to verify that the school will be submitting your GPA for you.

FOR SCHOOL USE ONLY SECTION

GPA IS BASED ON HIGH SCHOOL COURSEWORK: Fill in this bubble ONLY if the GPA is based on high school coursework.

CALIFORNIA COMMUNITY COLLEGE RE-ESTABLISHED GPA: Fill in this bubble ONLY if the GPA being certied is based on at least 16 but less than

24 units completed at a California Community College.

If the GPA is based on college units, and is not a reestablished GPA as described above, do not ll in any bubble.

GPA VERIFIER’S SCHOOL CODE: High schools use their College Board school code; colleges use their USED OPE ID

code.

VERIFIED STUDENT GPA: Fill in ALL three GPA spaces. Cal Grant GPAs are calculated on a 4.00 scale. High

Schools certifying GPAs MUST be accredited or have a UC approved course list in

order to verify GPAs. Students not attending accredited high schools should provide

either a GED, SAT or ACT score.

After the school completes the GPA information, fold form into thirds, insert into a #10 standard business envelope, apply the

appropriate postage and mail to:

California Student Aid Commission

Cal Grant Operations

P.O. Box 419077

Rancho Cordova, CA 95741-9077 G-4 (11/2009)

REGIONAL ACCREDITATION AGENCY (High schools only) Please enter the Regional accreditation agency in

which your High school is accredited.

Cal Grant GPA Calculation Instructions

High School GPA

A high school GPA is calculated on a 4.00 scale to two decimal

places (between 0.00 and 4.00). Do not use a weighted scale.

Convert any grades with extra weighting for honors and

advanced placement classes to a 4.00 scale before calculating

the GPA. GPAs calculated beyond a 4.00 scale will not be

accepted.

For students who have not yet graduated high school, calculate

the GPA using all academic course work for the sophomore

year, the summer following the sophomore year, the junior year,

and the summer following the junior year. The high school GPA

excludes physical education (PE), Reserve Ofcer Training

Corps (ROTC), and remedial courses. Remedial work is dened

as any course that is not counted toward high school graduation.

Failing grades must be included in the GPA calculation unless

the course has been retaken.

GPAs for “accelerated” high school juniors graduating in spring

2010 should be calculated using academic course work earned

during the student’s sophomore year and the summer following

the sophomore year, as well as all course work completed in the

junior year by the time of certication.

For students who are out of high school but have not earned

sufcient college level units to allow calculation of either a

college GPA or reestablished GPA or as explained below, the

GPA must be calculated from high school course work earned

from the student’s sophomore year onward, regardless of

whether the student graduated. Competitive Cal Grant awards

can be made to students who have not graduated high school.

Regular California Community College GPA

For purposes of computing a community college GPA for a Cal

Grant award, “nontransferable units” and “courses not counted

in the computation for admission to a California public institution

of higher education that grants a baccalaureate degree” mean

all courses except “Associate Degree Credit Courses” as dened

by Title 5, Chapter 6, Article 1, Section 55002(a) of the California

Code of Regulations.

Reestablished Community College GPA

A reestablished community college GPA is calculated on at least

16 but less than 24 semester units or the equivalent. For any

Cal Grant deadline, a school may submit either a reestablished

GPA or a “regular” community college GPA calculated on at

least 24 semester units, or the equivalent. A reestablished

GPA is good only for Competitive Cal Grant B consideration.

Only a California Community College may submit a

reestablished GPA.

College GPA

A college GPA is calculated on all college work completed,

except for nontransferable units and courses not counted in

the computation for admission to a California public institution

of higher education that grants a baccalaureate degree.

The denition of the phrases “all college work completed”

and “nontransferable units” and “courses not counted in the

computation for admission to a California public institution

of higher education that grants a baccalaureate degree” are

described below. A college GPA or a community college GPA

must be computed for a minimum of 24 semester units or its

equivalent regardless of the grades received. The phrase “all

college work completed” includes all coursework for which

grades are known to the ofcial reporting the GPA and that are

accepted for credit at the school reporting the GPA. Failing

grades must be included.

College GPA - Baccalaureate Degree Granting

Institution

College GPA - Associate Degree Granting

Institution

For purposes of computing a college grade point average by

a postsecondary institution that grants an associate degree,

“nontransferable units” and “courses not counted in the

computation for admission to a California public institution of

higher education that grants a “baccalaureate degree” are those

courses which do not earn credit for an associate degree at teh

reporting institution.

College GPA - Non-degree Granting Institution

For purposes of computing a college GPA by a postsecondary

institution that does not grant a baccalaureate or an associate

degree:

(A) “nontransferable units” are those units which are not used in

satisfying requirements for earning a baccalaureate degree from

a California public institution of higher education that grants such

a degree;

(B) “courses not counted in the computation for admission to

a California public institution of higher education that grants a

baccalaureate degree” are any courses for which the earned

grade is not used in the computation of a GPA in determining

admission eligibility, whether or not units earned for the course

are transferable to such an institution.

There are four categories of GPAs used for Cal Grant award selection - High School, College, Regular

Community College and Reestablished Community College.

For purposes of computing a college GPA by an institution

that grants a baccalaureate degree, “nontransferable units”

and “courses not counted in the computation for admission to

a California public institution of higher education that grants a

baccalaureate degree” are those courses which do not earn

credit for a baccalaureate degree from the reporting institution.

If the GPA is based on college units, and is not a reestablished GPA as described above, do not ll in any bubble.

Fill Online, Printable, Fillable, Blank 2010-11 March2GPA Form Form

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Fillable 2010-11 March2GPA Form

Fill Online, Printable, Fillable, Blank 2010-11 March2GPA Form Form

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