6ummer GRAD PLUS Loan Request Form
LOAN REQUEST INFORMATION
Term Applying For:
I am requesting a loan in the amount of: $
Instructions: Borrower must complete ALL sections below; print clearly in BLUE or BLACK ink; read and SIGN the
Authorizing Statements and return to the Office of Financial Aid. Borrower must complete a 2018/2019 FAFSA.
My signature indicates that I am applying for, am eligible to receive, and accept a Federal Direct GRAD PLUS Loan in the
amount requested above.
I authorize th
e U.S. Department of Education to investigate my credit record and determine my credit worthiness for this loan.
I certify th
at any funds received from this loan will be used for expenses related to my attendance at Tennessee Technological
University, that I am eligible to receive the proceeds of this loan, and that the information provided on this form is complete
and accurate to the best of my knowledge.
I understa
nd that the acceptance and processing of this request form does not guarantee credit approval. I also understand that I
must apply for approval of this loan with the U.S. Department of Education by completing a Federal Direct GRAD PLUS Mas-
ter Promissory Note (MPN) and complete GRAD PLUS entrance counseling (which is separate from the Federal Direct Staf-
ford entrance counseling).
I further certify that I am not in default on an education loan and do not owe a refund on a federal grant.
This Federal Dir
ect GRAD PLUS Loan process may take up to 3 weeks for processing. I understand that if these funds are not
available to pay any balance owed the University, I am responsible for any balance due according to the University Bursar’s
deadlines.
Student Borrower Signature _____________________________ Date: ________________________
_________________________________________ ______________________________________
Student Social Security Number T #
_______________________________ _____________________________ ________________________
Student Borrower Last Name Student Borrower First Name Student Borrower Middle Initial
_________________________________________________________________________________________________
Student Borrower Permanent Home Address
_______________________________ ______________________________ _________________________
Student Borrower City Student Borrower State Student Borrower Zip
_______________________________ ______________________________ _________________________
Student Borrower Date of Birth Student Borrower Home Telephone Number Student Borrower Cell Phone Number
_______________________________ ______________________________ _________________________
Student Borrower Driver’s License Number State of Issuance Student Borrower Email Address
Student
Borrower Citizenship Status: (check one) US Citizen Permanent Resident/Eligible Non-Citizen
A_____
_________________________________
Alien Registration Number if Non-Citizen
Summer 2019 only
Office of Financial Aid financialaid@tntech.edu
Mailing Address: Physical Address:
1000 N. Dixie, Box 5076 805 Quadrangle
Cookeville, TN 38505 Jere Whitson Bldg, Rm 302
Ph: 931-372-3073 Fax: 931-372-6309
