As set forth in full in the Student Handbook/Course Catalog, Southern Crescent Technical College is an Equal Opportunity Institution and does not discriminate on the basis of race, color,
national origin, sex, age or disability.
Revised6‐27‐19
2019-2020 High School Graduation Self-Certification
Please Type or Print clearly in BLUE or BLACK ink
Student’s Information
______________________________________________________ ________________________________
Student’s Last Name Student’s First Name Student’s M.I. Southern Crescent Student ID #
____________________________________________________________
Student’s Street Address (include apt. no.) Student’s Date of Birth
____________________________________________________________
City State Zip Code Student’s Email Address
____________________________________________________________
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone Number
What will your high school completion status be when you begin college in the 2019-2020 school year (check box below):
I certify that I have graduated from high school:
High School Name ______________________________________________________________________
High School City _______________________________________
High School State ____________________________________
Date of Graduation ____________________________
I certify that I have successfully complete a General Education Development (GED) program.
I certify that I have successfully completed a homeschool
None of the above
Will you have your first bachelor’s degree before you begin the 2019-2020 school year?
Yes _____________
No _____________
If the student is unable to obtain the documentation listed above, he or she must contact the Office of Financial Aid.
Certification and Signature
__________________________________________________ ___________________________
Student’s SignatureDate
Office of Financial Aid
501 Varsity Road 1533 Hwy 19 South 300 Lakemont Drive
Griffin, GA 30223 Thomaston, GA 30286 McDonough, GA 30253
770-228-7368 p 706-646-6386 p 770-914-4411 p
770-229-3029 f 706-646-6063 f 770-229-3236 f
Each person signing below certifies that all of the information reported in
this worksheet is complete and correct. The student must sign this
worksheet.
WARNING: If you purposely give false or
misleading information on this worksheet,
you may be fined, be sentenced to jail, or both.
Please submit this worksheet to the Office of Financial Aid
click to sign
signature
click to edit
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