2019-2020 Identity/Statement of Educational Purpose Verification
Financial Aid Office, 1637 Lawson Street, Durham NC 27703
Phone 919-536-7209, Fax 919-536-7260, financialaid@durhamtech.edu
A. Student Information (Required)
Date of Birth
Student ID
Phone Number
Street Address
State and Zip
B. High School Completion (Required)
Please check the box that is applicable.
I have provided proof of high school completion to Durham Tech Student Information and
Records office (Examples: High School or GED diploma or official high school or GED
transcript sealed in an envelope.)
I have attached proof of high school or GED completion.
C. Identity and Statement of Education Purpose
The student must appear in person at Durham Technical Community College to verify his or her identity
by presenting an unexpired valid government-issued photo identification (ID), such as, but not limited
to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the
student’s photo ID that is annotated by the institution with the date it was received and reviewed, and
the name of the official at the institution authorized to receive and review the student’s ID. In addition,
the student must sign, in the presence of the institutional official, the Statement of Educational Purpose
provided below.
Statement of Educational Purpose
certify that I (print student name) ______________________________________ am the individual
signing this Statement of Educational Purpose and that the Federal student financial assistance I may
receive will only be used for educational purposes and to pay the cost of attending Durham Technical
Community College for 20192020.
Student Signature: ________________________________________ Date: ________________
Student ID: ______________________
Verified By:
Financial Aid Representative (Print) _______________________________________ Date: ___________
Financial Aid Representative Signature _______________________________________
Revised Spring 2018
D. Submit a copy of your State Identification (Required)
Note this must be a non-expired government issued photo ID such as a Driver’s License or
Passport. Durham Technical Community College Student ID’s are not acceptable.
E. Certification and Signatures
NOTE: This must be hand-signed. Electronic signatures of any form is not permissible.
Each person signing below certifies that all of the information reported is complete and correct.
WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or
Student Signature: ___________________________________ Date: __________________________
Revised Spring 2018
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome