Version 02/10/2020
2020-2021 Identity and Statement of Educational Purpose
Federal Student Aid Programs
Student Information (please print):
_________________________________________________________ _____________________/_________________ ________________________
Last Name, First Name, Middle Initial Social Security# and Student ID (A Number) Date of Birth
________________________________________________________ _______________________________________________________________________
Address City State Zip
_________________________________________________________ _______________________________________________________________________
Phone Number (include area code) Email Address
Identity and Statement of Educational Purpose
(To Be Signed at the Institution)
The student must appear in person at Calhoun Community College to verify his or her identity by presenting a valid
government-issued photo identification (ID), such as but not limited to a driver’s license, other state-issued ID, or
passport. The institution will maintain a copy of student’s photo ID that is annotated with the date it was received and
the name of the official at the institution authorized to collect the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the following:
Statement of Educational Purpose
I certify that I, ____________________________________________________________, am the individual signing
(Print Student’s Name)
this Statement of Educational Purpose and that the federal student financial assistance I may receive will only be
used for educational purposes and to pay the cost of attending Calhoun Community College for 2020-2021.
___________________________________ ______________________ ______________________
Student’s Signature Student’s ID (A Number) Date
Signature or Official Receiving ID
Please note that processing may take 3 4 weeks after documents are received especially during peak processing.
Signature of Official Receiving ID
Date Received
Copy of Id attached
V4 / V5
I have agreed to submit this application by electronic means. By signing this application electronically, I certify under
penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge.
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written