FAMILY INFORMATION
CERTIFICATIONS AND SIGNATURES
HOUSING INFORMATION
Financial Aid Office
3200 West C Street
Torrington, WY 82240
p: 307.532.8224
f: 307.532.8222
financialaid@ewc.wy.edu
2017-2018
Unaccompanied Homeless
Youth Verification
On your FAFSA you answered “Yes” that you received a determination on or after July 1, 2016, that you were either an unaccompanied
youth who was homeless ~OR~ at risk of being homeless.You may be eligible for additional educational services through Title X, Part
C, Federal McKinney-Vento Assistance Act. Eligibility can be determined by completing this questionnaire. Additional information is
included with this form.
___________________________________________________________ ____________________ __________________________
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 the appropriate response below and follow instructions given.
I rent/own my own home.
If you rent/own your own home, STOP here. Sign at the bottom of this form and turn in to EWC’s Financial Aid Office.
I do NOT rent/own my own home.
Please describe your living arrangements (where do you live, with whom do you live) below and have a designated official
complete the back side of this form. Attach a separate page if you need more room for your explanation.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
List the members living in your family’s household, including:
• Yourself and others in your household.
• Your parent(s) and stepparents (even if you do NOT live with them) IF they provide you with ANY support
(i.e. medical/auto insurance, car payment, cell phone bill, allowance, educational expenses, rent, etc.).
Full name of household member Age Relationship to student College attending/employer
Self EWC
The undersigned certifies that the above information provided is accurate.
___________________________________________________________________________________________
Print Student Name Signature Date
___________________________________________________________________________________________
Print Parent/Guardian Name/Adult Caring for Student Signature Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
STUDENT INFORMATION
2017-2018 Unaccompanied Homeless Youth Verification
For the Purposes of Federal Financial Aid
This form is to be completed by a designated official
I am providing this letter of verification as a (check one):
A McKinney-Vento School District Liaison
A director or designee of a HUD-funded shelter (shelter name):________________________________________
A director or designee of a RHYA-funded shelter (shelter name):_______________________________________
This letter is to confirm that __________________________________________________was:
Print student name
an unaccompanied homeless youth after July 1, 2016.
After July 1, 2016, the student listed above was living in a homeless situation, as defined by Section 725 of the
McKinney-Vento Act, and was not in the physical custody of a parent or guardian.
an unaccompanied, self-supporting youth at risk of homelessness after July 1, 2016.
After July 1, 2016, the student listed above was not in the physical custody of a parent or guardian, provides for
his/her own living expenses entirely on his/her own, and is at risk of losing his/her housing.
As per the College Cost Reduction and Access Act (Public Law 110-84), I am authorized to verify this student’s
living situation. No further verification by the Financial Aid Administrator is necessary. Should you have
additional questions or need more information about this student, please contact me at the number listed below.
Date
Telephone Number
Title
Agency
School Use Only
___Approved
___Denied
___Requested Additional Information: ________________________________________________________
__________________________________________________________________________________________
Print School Contact Title Signature Date
Return completed form to:
Eastern Wyoming College
Financial Aid Office
3200 West C Street
Torrington, WY 82240
(307) 532-8224 or 1-866-327-8996 Ext 8224
Fax: (307) 532-8222
Unaccompanied Homeless Youth Fact Sheet
Beginning with the 2009-2010 academic year, the definition of an “independent student” was expanded to
include any applicant who had been verified during the school year in which the application is submitted
as either:
An unaccompanied youth who is a homeless child or youth, as such terms are defined in section 725
of the McKinney-Vento Homeless Assistance Act; or
An unaccompanied youth who is at risk of homelessness and is also self-supporting.
Verification Requirements
Students who apply for assistance as an unaccompanied youth who is a homeless child or youth, as such
terms are defined in section 725 of the McKinney-Vento Homeless Assistance Act should be able to provide
documentation of their status from a McKinney-Vento School District Liaison, a director or designee of a
HUD-funded shelter, or a director or designee of a RHYA-funded shelter.
Critical Definitions
McKinney-Vento and CCRAA Definition of Homelessness: Children who lack a fixed, regular, and adequate
nighttime residence which includes
Living in shelters, motels, cars, OR
Temporarily living with other people because the applicant had nowhere else to go.
The education subtitle of the McKinney-Vento Act is overseen by the U.S. Department of Education.
For more information, see: http://www2.ed.gov/policy/elsec/leg/esea02/pg116.html
Unaccompanied Youth: Unaccompanied homeless youth are young people who lack safe, stable housing and
who are not in the care of a parent or guardian. They may have run away from home or been forced to leave by
their parents. Unaccompanied youth live in a variety of temporary situations, including shelters, the homes of
friends or relatives, cars, campgrounds, public parks, abandoned buildings, motels, and bus or train stations.
“Youth” means that the applicant (student) is 21 years of age or younger OR that the applicant is still enrolled in
high school as of the day he/she completes the FAFSA. Students who don’t meet the definition of youth because
they are older than 21 (and not yet 24) and who are unaccompanied and homeless or self-supporting and at risk of
being homeless qualify for a homeless youth determination.
McKinney-Vento School District Liaisons: Under subtitle VII-B of the McKinney-Vento Homeless Assistance
Act, every school district is required to designate a liaison for students experiencing homelessness. Homeless
liaisons have a number of legal responsibilities under the Act, including identifying youth who meet the definition
of homeless and are unaccompanied. A local educational agency (LEA) homeless liaison, designated pursuant to
722(g)(1)(J)(ii) of the McKinney-Vento Homeless Assistance Act; To find local liaisons: contact the Office
State Coordinator for the Education of Homeless Children and Youth.
See: serve.org/nche/states/state_resources.php
.
HUD-funded Shelters: The U.S. Department of Housing and Urban Development (HUD) administers funding
for homeless shelters and services under Title IV of the McKinney-Vento Act. These funds are distributed to
communities through a competitive grant process.
For more information, see: https://www.hudexchange.info/homelessness-assistance/
RHYA-funded Shelters: The U.S. Department of Health and Human Services administers the Runaway and
Homeless Youth Act programs. These programs provide funding for Basic Centers, Transitional Living Programs,
and Street Outreach Programs that serve runaway and other unaccompanied homeless youth.
o For more information, see: http://www.acf.hhs.gov/fysb/programs/runaway-homeless-youth
o The director or a designee of the director of a program funded by the Runaway and Homeless Youth Act.
To find Runaway and Homeless Youth Act service providers go to:
http://www.acf.hhs.gov/fysb/grants/fysb-grantees
11/2016