Revised6‐26‐19
2019-2020 Unusual Enrollment History
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. Students School ID#
Your 2019-2020 Free Application for Federal Student Aid (FAFSA) was flagged for Unusual Enrollment History because you received
Federal Pell Grant funds at multiple education institutions during the review period, 2016-17, 2017-18, and 2018-19. The Department
of Education requires that before awarding additional Federal Pell Grant, Southern Crescent Technical College (SCTC), must confirm
enrollment information reported on your FAFSA. To verify that you are eligible to receive additional Federal Pell Grant for 2019-
2020, SCTC will compare your previous enrollment, academic and/or financial aid records.
Please provide required documentation listed below. Your application for financial aid will not be considered until you submit
this completed form and required documentation.
You must list all schools that you attended during the –2016-17, 2017-18, and 2018-19 academic years.
You must provide official academic transcript or grade reports for EACH school listed below.
You must provide a statement for each school listed below explaining the reason for your failure to earn any academic credit at
the institution while receiving Federal Pell Grant funds during the review period. If you answer ‘No’ to Earn Credit, please
attach any relevant documentation (i.e., medical bills, hospitalization records, accident reports, etc.)
School Dates Attended Earn Credits
YesNo*
YesNo*
YesNo*
YesNo*
YesNo*
YesNo*
Certification and Signatures:
By signing this form I certify that the information reported and submitted on it is complete and correct. Purposely giving false and
misleading information on this worksheet, you may be fined, sentenced to jail or both.
Student Signature Date
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.
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
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