Financial Aid
450 North Avenue • Battle Creek, MI 49017-3397
269-965-4123 • FAX 269-966-4089
www.kellogg.edu/nancial-aid
KELLOGG
COMMUNITY COLLEGE
2019-2020
Parent Information Form
FSN/MSN
Student Name (please print legibly) Student ID#
The Student is required to submit the information requested below for at least one of the parents/step-parents the student identied
on the Free Application for Federal Student Aid (FAFSA) for the school year 2019-2020. This should be the parent/step-parent that the
student currently resides with, or most recently resided with.
The information requested on this form is required for the continued processing of the student’s application for Federal Student Aid.
Failure to provide this information will cause the student application to NOT be processed. You may make these changes to your FAFSA
application and notify our oce.
At a minimum, information and signature of at least one parent/step-parent is required.
The following information for your parent(s) is required to complete your nancial aid application. Please complete all applicable
sections below with current information and return to KCC Financial Aid.
FATHER/STEPFATHER INFORMATION
Father/Stepfather Full Name
Father/Stepfather Address
Father/Stepfather City, State, Zip
Father/Stepfather Date of Birth
Marital Status and Date
Father/Stepfather Social Security # (enter all zero’s if None)
Father/Stepfather Signature _______________________________ Date ____________________
MOTHER/STEPMOTHER INFORMATION
Mother/Stepmother Full Name
Mother/Stepmother Address
Mother/Stepmother City, State, Zip
Mother/Stepmother Date of Birth
Marital Status and Date
Father/Stepfather Social Security # (enter all zero’s if None)
Mother/Setpmother Signature _______________________________ Date ____________________
Updated 3/19
