2019-2020 Bachelor’s Degree /Selective Service Confirmation Form
Student Name: Student ID:
Bachelor’s Degree Question
I have NOT obtained a bachelor’s degree.
I have obtained a bachelor’s degree.
Selective Service Question
I am a female student and am not required to register for the Selective Service.
By signing below, I am acknowledging that I am reporting accurate information that will be used to determine
my financial aid eligibility. If it is determined that I reported inaccurate information, I understand that my
aid may be cancelled and I will be responsible for repayment of any aid that had previously been disbursed.
Student Signature Date
Revised: October 18, 2018
Notifications of nondiscrimination and contact information can be found at www.ccac.edu, search keywords “notifications of nondiscrimination.”
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