CERTIFICATION AND SIGNATURE
3200 West C Street
Torrington, WY 82240
p: 307.532.8224
f: 307.532.8222
financialaid@ewc.wy.edu
2017-2018
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 from Eastern Wyoming College. Federal financial aid includes the Federal Pell
Grant, Federal Supplemental Educational Opportunity Grant, Iraq and Afghanistan Service Grant, Federal Work Study, and
Direct Student Loans.
___________________________________________________________ ____________________ __________________________
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)
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 which 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 in the College Catalog and on the EWC website. 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.
11/2016
DEGREE/CERTIFICATE STATUS INFORMATION
