DEGREE/CERTIFICATE STATUS INFORMATION
CERTIFICATION AND SIGNATURE
Mail: Financial Aid Office
Eastern Wyoming College
3200 West C Street
Torrington, WY 82240
2014-2015
Degree/Certificate-Seeking
Status
In order to be eligible to receive Title IV Federal Financial Aid, students must be enrolled in an eligible program as a
regular student seeking a degree or certificate. Federal financial aid includes the Federal Pell Grant, Federal Supplemental
Educational Opportunity Grant, Iraq and Afghanistan Service Grant, Federal Work Study, and Federal Direct Student
Loans.
______________________________________________________________ __________________________________________
Last Name First Name M.I. EWC Student ID Number
______________________________________________________________ __________________________________________
Address (include apartment number) Social Security Number (last four digits)
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City, ST, Zip Phone Number (include area code)
Please check one of the following options:
□ I am enrolled in an associate’s degree program at EWC.
List degree/major: ________________________________________________________________________
□ I am enrolled in a certificate program at EWC.
List certificate/major: ______________________________________________________________________
□ I would like to be enrolled in the following degree or certificate program:
List degree or certificate: __________________________________________________________________
If you are unsure of what major you would like to pursue, but are intending to earn an associate’s degree,
you may choose AA in Interdisciplinary Studies or AS in Interdisciplinary Studies. Review EWC’s Catalog
for details. Note: Students may change their major at a later date if necessary.
□ I am NOT seeking a degree or certificate from EWC. I understand I am not eligible to receive Title IV
Federal Financial Aid and some types of scholarships from EWC.
By signing this worksheet, I certify that all of the information reported is complete and correct. I also acknowledge that I have read and
agree to comply with all verification policies as stated by EWC. Failure to submit information in a timely fashion may result in the
application being filed as inactive with no further consideration and no federal aid for the academic year.
Student signature: _______________________________________________ Date: ____________________________
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
2/12/14
