Directions: To apply for the reduction, international students must apply to attend COS and must submit the fee reduction
application to the Financial Aid Office. The Director of Financial Aid will determine if the student meets the California
College Promise Grant eligibility criteria, which shall be the standard for financial need.
Applicants will be selected on a “first-come, first-serve” basis using the date of completion of their application, although no
more than one fee reduction will be granted per country of origin.
The Student Services Office will keep a record and current roster of approved reductions. Reductions will remain in effect
for two calendar years, if the student is enrolled in and completes a minimum of 12 units each semester and has a
minimum COS GPA of 2.00. After two years, students must reapply if they wish to be considered for additional semesters.
Step 1 Complete a paper FAFSA https://fafsa.ed.gov/fotw1819/pdf/PdfFafsa18-19.pdf
Step 2 Complete the following California College Promise Grant questions:
1. Were you born before January 1, 1988? Yes No
2. As of today, are you married? (Answer “Yes” if you are separated but not divorced.) Yes No
3. Do you have children who receive more than half of their support from you or other dependents who live with you (other
than your children and spouse) who receive more than half of their support from you, now and through June 30, 2017?
Yes No
4. Are you an orphan or ward of the court, or were you a ward of the court until your 18th birthday? Yes No
If you answered “Yes” to any of the questions 1 4, you are considered an INDEPENDENT student and must
provide income and household information about yourself (and your spouse if you are married). Skip to Section B.
If you answered “No” to all questions 1 4, complete questions 5 and 6.
5. Do you (or did you prior to your arrival at Siskiyous) live with your parents? Yes No
6. Do your parents provide more than half your support? Yes No
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Term: Fall Spring Summer Year 20
Student ID: Last First
Permanent Home Address: Address while attending COS
Phone: Phone:
Date of Birth: Email address:
Marital Status: Single Married Divorced Separated Widowed
If you answered “No” to questions 1 4 and “Yes” to question 5 or 6, you must provide income and household information
about your PARENT(S) and answer questions for a DEPENDENT student in Section B.
1. DEPENDENT STUDENT: How many persons are in your parent(s) household? (Include yourself, your parent(s), and
anyone who lives with your parent(s) and received more than half of their support from your parents, now and through
June 30, 2017.)
2. INDEPENDENT STUDENT: How many persons are in your household? (Include yourself, your spouse, and anyone
who lives with you and receives more than half their support from you, now and through June 30, 2017.)
For questions 3 and 4, please convert the income into American dollars.
3. 2017 Income Information
a. Adjusted Gross Income $ $
(If 2017 U.S. Income Tax Return
was filed, enter the amount from
Form 1040, line 37; 1040A,
Line 21; 1040EZ, line 4 or
Telefile, line I). If not U.S. income,
report all income earned from work
for 2017.
b. All other income $ $
(Include ALL money received in 2017
that is not included in line (a) above.
Be sure to include all untaxed income.)
4. Total Income for 2017 $ $
(Sum of a + b)
I hereby swear and affirm, under penalty of perjury, that all information on this form is true and complete to the best of my
knowledge. If asked by an authorized official, I agree to give proof in support of the information provided on this form. I
also realize that any false statement or failure to give proof when asked may be cause for the denial, reduction,
withdrawal, and/or repayment of my waiver.
Applicant’s Signature Date Parent Signature (Dependent Students Only) Date
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For Office Use Only
Meets California College Promise Grant income standards: Yes No
____________________________________ _________________________________
Signature, FAO Date