Fillable 2020-2021 Consortium Agreement must be complete before you (Eastern Wyoming College)

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2020-2021 Consortium Agreement must be complete before you (Eastern Wyoming College)

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Financial Aid Office
3200 West C Street
Torrington, WY 82240
p: 307.532.8224
f: 307.532.8222
financialaid@ewc.wy.edu
2020-2021
Consortium Agreement
A Consortium Agreement is an arrangement between two institutions for the financial benefit of a student who will be concurrently
enrolled at both institutions. Eastern Wyoming College (EWC) is willing and interested in participating in consortium agreements with
a student where the collaboration helps meet a student’s educational goals. The agreement allows a student to receive financial aid from
EWC as the home institution (HOME) for all eligible courses for which the student is enrolled, including those from a host institution
(HOST). It is the student’s responsibility to complete the agreement properly and ensure that all of the necessary steps are taken so that
funding may be delivered and academic credit granted for the courses completed. ALL fields are required. If a section is left blank
the form will be returned to you and marked as incomplete.
Important Points:
• Federal Aid Applicants/Recipients: You MUST be eligible for Title IV Federal Financial Aid and your financial aid process
must be complete before you will receive funds.
• Scholarship Recipients: Institutional funds and scholarships may or may not be eligible for the consortium process.
• You MUST be enrolled for a minimum of one class at EWC as HOME for this Agreement to be valid.
• You MUST meet and maintain EWC’s Satisfactory Academic Progress Policies for Financial Aid with the combination of
HOME and HOST grades and completion requirements.
• You MUST complete a new Consortium Agreement each semester of enrollment at a HOST school.
• You MUST be a degree- or certificate-seeking student at EWC to use this Agreement.
• Courses listed on this agreement MUST be required by your EWC program of study.
(If EWC is your HOST, contact your HOME institution for their consortium form and requirements.)
• Students who have lost financial aid eligibility may enroll with a HOST institution (depending on HOST requirements), but
cannot receive aid until aid eligibility is regained.
• You MUST request an official transcript be sent to the EWC Registrar from your HOST.
• You are responsible for all costs to the HOST. EWC cannot pay them on your behalf.
STUDENT INFORMATION
___________________________________________________________ ____________________ __________________________
Last Name First Name M.I. EWC Student ID Number Social Security Number (last four digits)
___________________________________________________________ _______________________________________________
Mailing Address (include apartment number) E-mail Address
___________________________________________________________ _______________________________________________
City, ST, Zip Phone Number (include area code)
Please indicate your reason for seeking a
consortium agreement:
Class not available at EWC
Schedule conflict with another EWC class
Other: ____________________________
Please indicate what type(s) of financial aid
you will be receiving during the semester of
an approved Consortium Agreement:
Federal aid
(Pell Grant, Direct Loan, Work-Study)
Hathaway Scholarship
Veterans Benefits
Other financial aid
Please indicate the enrollment term for this
Consortium Agreement (check one):
Fall 2020
Spring 2021
Summer 2021
Please note: You must complete this form each
semester for which you wish to receive financial
aid under a Consortium Agreement.
HOME AND HOST INFORMATION
EWC Location:
(Torrington, Douglas, Chugwater, Glendo, Glenrock, Guernsey, Hulett, Lusk, Moorcroft, Newcastle, Sundance, Upton, Wheatland)
Host School:
Host City/State:
It is the student’s responsibility to complete the agreement properly and ensure that all of the necessary steps are taken so that funding
may be delivered and academic credit granted for the courses completed. Please note: ALL fields are required. If a section is left
blank the form will be returned to you and marked as incomplete.
ENROLLMENT INFORMATION (Complete with EWC Academic Advisor or Registrar)
For a course to be eligible it must be offered by an accredited HOST eligible to participate in Title IV Federal Aid Programs and accepted by HOME
towards satisfying the student’s degree requirements. You MUST be enrolled in a minimum of one class at EWC as HOME for this Agreement to be
valid. Please work with your EWC Academic Advisor or EWC’s Registrar to complete the course enrollment information below:
What course(s) will the student be taking at HOST school?
Equivalent course(s) at EWC?
Course Subject
& Number
Course Title Credits
Course Title Credits
By signing below, Advisor/Registrar confirms that course(s) listed from HOST school are required for student’s EWC degree
program. A degree audit may be attached for proof of requirement.
Advisor or Registrar Signature: _____________________________________________________ Date: ________________________
Advisor or Registrar printed name: ________________________________________________________________________________
STUDENT AGREEMENT & CERTIFICATION
Please read the following expectations/Consortium Agreement Policies. After reading, please indicate agreement by writing (or typing,
if filling out the PDF version) your initials to the right of each statement (in the space provided).
1. I am taking (a) course(s) at the HOST school listed above that is/are transferable to my degree at EWC
2. I am NOT receiving financial aid at the HOST
3. I am enrolled in and attending at least one class at EWC for the Enrollment Term checked above and am making
Satisfactory Academic Progress as specified by EWC’s Satisfactory Academic Progress Policies for Financial Aid
4. I am enrolled in a degree/certificate program at EWC; EWC will confer my degree upon successful completion
of my program
5. I will notify EWC and HOST of any change in my enrollment status, including withdrawing from or not attending
courses:
If you drop or withdraw from courses at your host school, you are required to submit an official receipt of your
dropped courses to your consortium liaison at the home school. Please be aware that dropping or withdrawing from classes
in your consortium agreement may affect your SAP. You may only completely withdraw from a consortium agreement twice.
If you drop all courses at both schools, the home institution will perform a Return of Title IV Funds calculation and may return
funds to federal accounts. This could result in a bill on your student account.
6. I will submit an official grade transcript from my HOST school at the end of the semester
7. I am responsible for paying educational expenses at my HOST school
8. I authorize my HOST school to release any necessary academic and/or financial information for the above
course(s) to EWC
By signing below, I certify that I have read, and that I understand and will abide by all Consortium Agreement Policies
____________________________________________________________________________________________________________
Student’s Signature (Handwritten signature required) Date
Please return completed form to:
Financial Aid Office
3200 West C Street
Torrington, WY 82240
p: 307.532.8224
f: 307.532.8222
financialaid@ewc.wy.edu
Consortium Agreement
HOST SCHOOL Certification
STUDENT INFORMATION
Student Name:
(please print)
RECEIVING FEDERAL AID AT HOST NOT RECEIVING FEDERAL AID AT HOST
ONLY complete this section if the student will be receiving federal
financial aid at your institution.
Please select the types of federal aid the student will be receiving at
your institution:
Pell Grant/IASG/CFHS
Direct Subsidized Loan
Direct Unsubsidized Loan
Work-Study
FSEOG
Other: ____________________________
__________________________________
STOP. Do not complete the rest of the worksheet; sign below and return
to EWC or student only.
_________________________________________________________
HOST Financial Aid Officer’s Signature
ONLY complete this section if the student will NOT be receiving financial
aid at your institution.
Please provide the enrollment period and number of credits at HOST:
_____________ to _____________ # of credits enrolled: _______
mm/dd/yy mm/dd/yy
ASSOCIATED COSTS for ENROLLED SEMESTER
Tuition/Fees $ _________________________
Books/Supplies $ _________________________
Room/Board $ _________________________
Other $ _________________________
Other $ _________________________
HOST SCHOOL OFFICIAL’S SIGNATURE
The student’s funds will be disbursed directly to the student. It is the student’s responsibility to pay the balance due to the HOST.
I certify the above named student is registered at HOST listed for the enrollment period designated above in an academic program that
meets the Title IV student financial aid eligibility requirements. I certify that the HOST will not award any financial aid for the
enrollment period. I will notify EWC if the student does not begin attendance in the courses listed and approved in this consortium
agreement. I will inform EWC immediately of any change in enrollment status, including failure to attend course(s), withdrawing from
course(s), including withdrawal dates and/or last dates of attendance, or approval of any course substitution(s).
________________________________________________ _______________________________________________
HOST Financial Aid Officer’s Signature Please print or type name
________________________________________________ _______________________________________________
HOST Financial Aid Officer’s Title Date
________________________________________________ _______________________________________________
HOST School Street Address City, State, Zip
________________________________________________ _______________________________________________
HOST School Phone Number HOST School Fax Number or e-mail Address
Under this agreement, the HOST agrees to make available applicable student consumer information required under Title IV. Neither institution waives
its governmental immunity by entering into this Agreement. Both institutions fully retain all immunities and defenses provided by law. This Agreement
may be canceled by either institution upon written notification and will automatically terminate at the conclusion of the enrollment period identified.
2.14.2020
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2020-2021 Consortium Agreement must be complete before you (Eastern Wyoming College)

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Completed 27 July 2020

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