Office of Financial Aid
710 Colegate Drive, Marietta, OH 45750
Phone: 740.568.1908 Fax: 740.376.0257
2020-2021 Homeless Affirmation Form
Student Name: ___________________________________ WSCC ID: _______________ DOB: _____/_____/__________
On your 2020-2021 Free Application for Federal Student Aid (FAFSA), you indicated that you are an unaccompanied,
self-supporting youth who is homeless or at risk of homelessness. This qualifies you as an independent student for
financial aid purposes. Please read the following and check mark any of the statements in the box that apply to you:
Homeless, for financial aid purposes, means lacking fixed, regular and adequate housing, which includes living in
shelters, motels, a car, or temporarily living with other people because you, the student, had nowhere else to go.
Unaccompanied means that you are not living in the physical custody of your parent(s) or guardian.
Youth means that you are 21 years of age or younger or you are still enrolled in high school as of the day you
sign this application.
At any time on or after July 1, 2019 your high school or school district homeless liaison determined that you were
an unaccompanied youth who was homeless.
At any time on or after July 1, 2019, the director of an emergency shelter program funded by the US Department of
Housing and Urban Development determined that you were an unaccompanied youth who was homeless.
At any time on or after July 1, 2019, the director of a runaway or homeless youth basic center or transitional living
program determined that you were an unaccompanied youth who was homeless or were self-supporting and at
risk of being homeless.
If none of the previous situations describe your circumstances, you are considered a dependent student. In
this case, you must submit your parents’ information on your Federal Application for Federal Student Aid
If any of the above situations describe your circumstances, you must submit verification of your status from
a local educational homeless liaison, a director of an emergency shelter grant program under McKinney-
Veto Homelessness Act, a director of a program funded under Runaway and Homeless Youth Act, or by a
financial aid administrator. This verification must be submitted to our office on letterhead and must be
attached to this form.
Student Signature: _________________________________________________ Date: __________________________
Office Use Only
Approved? YES_______ No________ FAO Signature: _______________________________________________ Date:___________________