Office of Financial Aid
710 Colegate Drive, Marietta, OH 45750
Phone: 740.568.1908 Fax: 740.376.0257
2020-2021 Drug Conviction Eligibility Worksheet
Student Name: ___________________________________ WSCC ID: ______________ DOB: _____/_____/__________
On the 2020-2021 Free Application for Federal Student Aid (FAFSA) you either left question 31 blank or stated you
have a drug-related conviction. This makes you ineligible for federal and state financial aid.
However, you may become eligible for financial aid if any one of the following is true. Select one of the following
statements, if any, which is applicable to your situation:
You have successfully completed an acceptable drug rehabilitation program that included two
unannounced drug tests and is qualified to receive funds from a federal, state, or local government or
from a federally or state-licensed insurance company; or is administered or recognized by a federal, state,
or local government agency/court or a federally or state-licensed hospital/health clinic/medical doctor.
One year has elapsed from your first conviction date for possession of illegal drugs.
Two years have elapsed from your second conviction date for possession of illegal drugs.
Two years have elapsed from your first conviction date for the sale of illegal drugs.
The conviction was reversed, set aside, or otherwise rendered nugatory.
You left question 31 blank by mistake and have no drug-related convictions.
None of the above criteria are true in my situation. I understand that I am ineligible for financial aid and
will contact the Office of Financial Aid if my status changes.
When completing this form, you must only include federal or state convictions that occurred while you were a student
and were receiving federal financial aid. Do not include convictions for which you were treated as a juvenile. Do not
include convictions which have been removed from your record.
If you are convicted of possessing or selling drugs after you submit your FAFSA you must notify our office immediately.
You will lose your financial aid eligibility and be required to pay back all aid received after conviction.
SIGNATURE STATEMENT - I certify that the information reported on this form is true, complete and correct.
Student Signature _______________________________________________________ Date______________________
Office Use Only
Approved? YES_______ No________ FAO Signature: ___________________________________________ Date:___________________