Fill - Free fillable 2017 18 Consortium Agreement And Information (Eastern Wyoming College) PDF form

Consortium Agreement Information

A Consortium Agreement is an arrangement between two institutions for the financial benefit of a student who will be

concurrently enrolled at both institutions. Eastern Wyoming College (EWC) is willing and interested in participating in

consortium agreements with a student where the collaboration helps meet a student’s educational goals. The agreement

allows a student to receive financial aid from EWC as the home institution (HOME) for all eligible courses for which the

student is enrolled, including those from a host institution (HOST). For a course to be eligible it must be offered by an

accredited HOST eligible to participate in Title IV Federal Aid Programs and accepted by HOME towards satisfying

the student’s degree requirements. It is the student’s responsibility to complete the agreement properly and ensure that all

of the necessary steps are taken so that funding may be delivered and academic credit granted for the courses completed.

Important Points:

 You MUST be eligible for Title IV Federal Financial Aid and your financial aid process must be complete before

you will receive funds.

 Institutional funds and scholarships may or may not be eligible for the consortium process.

 You MUST be enrolled for a minimum of one class at EWC as HOME for this Agreement to be valid.

 You MUST meet and maintain EWC’s Satisfactory Academic Progress Policies for Financial Aid with the

combination of HOME and HOST grades and completion requirements.

 You MUST complete a new Consortium Agreement each semester of enrollment at a HOST school.

 You MUST be a degree- or certificate-seeking student at EWC to use this Agreement. (If EWC is your HOST,

contact your HOME institution for their consortium requirements.)

 Students who have lost financial aid eligibility may enroll with a HOST institution (depending on HOST

requirements), but cannot receive aid until aid eligibility is regained.

 You MUST request an official transcript be sent to the EWC Registrar from your HOST.

 You are responsible for all costs to the HOST. EWC cannot pay them on your behalf.

Consortium Agreement Policies:

1) The student seeking a degree from HOME but wishing to enroll for credit at HOST will receive financial aid only from

the HOME. All financial aid awards will be made by HOME based on policies of the HOME. Per federal regulations,

students may only receive federal financial aid from one institution during a period of enrollment.

2) The construction of the student’s Cost of Attendance for financial aid purposes will reflect the HOME cost.

3) Payment of institutional charges by financial aid at HOME will be done according to the HOME disbursement

procedures. Any excess funds will be disbursed to the student. The student is responsible for payment of all costs

due to HOST according to the schedule required by that institution.

4) To ensure transferability of course work from HOST to HOME, the student’s HOME academic advisor or EWC

coordinator (if attending an EWC Outreach site) must approve the student’s proposed schedule of courses at the HOST

as listed on the Financial Aid Consortium Agreement.

5) It is the student’s responsibility to keep the HOME Financial Aid Office informed of any course withdrawals.

6) A separate Agreement must be completed every semester for which the student wishes to take courses at another

institution and have them counted toward degree requirements and financial aid eligibility.

7) The student must be enrolled at EWC during the term covered by this Agreement. Students wishing to enroll for

courses at either the HOME or HOST must apply and be officially accepted for admission at the institution(s) offering

the courses. Exceptions may be made on a case-by-case basis.

8) The HOST will document the last date of attendance in all its classes, if requested by the HOME.

9) It is the student's responsibility to ensure that an official academic transcript from the HOST representing work

attempted under this Agreement arrives at HOME in a timely manner.

10) As a condition of this Agreement, the student authorizes both HOME and HOST to share all relevant information

relating to the student's application for and receipt of financial aid, if that information is needed by the other institution.

The student's signature on this form also indicates that he/she is aware that the proceeds of all financial aid received for

the applicable term must be used only for educational expenses incurred at the HOME and HOST.

11) Neither institution waives its governmental immunity by entering into this Agreement. Both institutions fully retain all

immunities and defenses provided by law. This Agreement may be canceled by either institution upon written

notification and will automatically terminate at the conclusion of the enrollment period identified.

6/22/2017

Financial Aid Office

3200 West C Street

Torrington, WY 82240

p: 307.532.8224

f: 307.532.8222

financialaid@ewc.wy.edu

2017-2018 Consortium Agreement

between

Eastern Wyoming College

and

____________________________________

Name of HOST Institution

Eastern Wyoming College and the above named school are herein entering into a Consortium Agreement for:

___________________________________________________________ ____________________ __________________________

Last Name First Name M.I. EWC Student ID Number Social Security Number (last four digits)

___________________________________________________________ _______________________________________________

Mailing Address (include apartment number) E-mail Address

___________________________________________________________ _______________________________________________

City, ST, Zip Phone Number (include area code)

EWC Campus Location: _______________________________________________________________________________

(Torrington, Douglas, Chugwater, Glendo, Glenrock, Guernsey, Hulett, Lusk, Moorcroft, Newcastle, Sundance, Upton, Wheatland)

Enrollment Term (check one): Fall 20____ Spring 20____ Summer 20____

Note: Student must complete this form each semester for which he/she wishes to receive financial aid under a Consortium Agreement

I am receiving: Federal aid (e.g., Pell Grant or Direct Loan) Hathaway Scholarship Other financial aid

Reason for consortium: Class not available at EWC Schedule conflict with another EWC class Other: _______________

By signing below, I certify that I understand and will abide by the Consortium Agreement Policies, including the following:

1. I am taking (a) course(s) at the HOST school listed above that is/are transferable to my degree at EWC,

2. I am NOT receiving financial aid at the HOST,

3. I am enrolled in and attending at least one class at EWC for the Enrollment Term checked above and am making Satisfactory

Academic Progress as specified by EWC’s Satisfactory Academic Progress Policies for Financial Aid,

4. I am enrolled in a degree/certificate program at EWC; EWC will confer my degree upon successful completion of my program,

5. I will notify EWC and HOST of any change in my enrollment status, including withdrawing from or not attending courses,

6. I will submit an official grade transcript from my HOST school at the end of the semester,

7. I am responsible for paying educational expenses at my HOST school,

8. I authorize my HOST school to release any necessary academic and/or financial information for the above course(s) to EWC.

____________________________________________________________________________________________________________

Student’s Signature Date

What course(s) are/is the student taking at HOST school?

Equivalent course(s) at EWC?

Course # Course Title Credits Course # Course Title Credits

By signing below, Advisor confirms that course(s) listed from HOST school are required for student’s EWC degree program.

Academic Advisor’s Signature: Date:

Academic Advisor’s printed name:

STUDENT INFORMATION

EWC (HOME) INFORMATION: To be completed by STUDENT

ENROLLMENT INFORMATION: To be completed by Academic Advisor at EWC

STUDENT CERTIFICATION

Select one

HOST SCHOOL CERTIFICATION

HOST SCHOOL OFFICIAL’S SIGNATURE

Student’s Name (please print): ___________________________________________________________________________________

Will the student listed above receive federal financial aid at your institution? Yes No

If “Yes”, please list type(s): ______________________________________________________________________________________

If “Yes”, STOP. Do not complete rest of section; sign here and return to EWC or student only: ________________________________

If “No”, please complete the remainder of this form.

Enrollment period at HOST: _____________ to _____________ # of credits enrolled in at HOST: _______________________

mm/dd/yy mm/dd/yy

Associated costs: Tuition/Fees $ _________________________

Books/Supplies $ _________________________

Room/Board $ _________________________

Other $ _________________________

The student’s funds will be disbursed directly to the student. It is the student’s responsibility to pay the balance due to the HOST.

I certify the above named student is registered at HOST listed for the enrollment period designated above in an academic program that

meets the Title IV student financial aid eligibility requirements. I certify that the HOST will not award any financial aid for the

enrollment period. I will notify EWC if the student does not begin attendance in the courses listed and approved in this consortium

agreement. I will inform EWC immediately of any change in enrollment status, including failure to attend course(s), withdrawing from

course(s), including withdrawal dates and/or last dates of attendance, or approval of any course substitution(s).

________________________________________________ _______________________________________________

HOST Financial Aid Officer’s Signature Please print or type name

________________________________________________ _______________________________________________

HOST Financial Aid Officer’s Title Date

________________________________________________ _______________________________________________

HOST School Street Address City, State, Zip

________________________________________________ _______________________________________________

HOST School Phone Number HOST School Fax Number or e-mail Address

Under this agreement, the HOST agrees to make available applicable student consumer information required under Title IV. As

HOME, EWC retains responsibility for enrollment reporting of all credits to the National Student Loan Data System (NSLDS). Neither

institution waives its governmental immunity by entering into this Agreement. Both institutions fully retain all immunities and defenses

provided by law. This Agreement may be canceled by either institution upon written notification and will automatically terminate at the

conclusion of the enrollment period identified.

Please return to:

Eastern Wyoming College • 3200 West C Street • Torrington, WY • 82240

Fax: 307.532.8222

E-mail: terri.hauf@ewc.wy.edu

Phone: 307.532.8326

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