Financial Aid
937.328.6034 | financialaid@clarkstate.edu | 570 East Leel Lane, Springfield, Ohio 45505
2020-2021
Prior Degree Confirmation
Financial Aid
FAC20PRD
You reported on the 2020/2021 Free Application for Federal Student Aid (FAFSA) that you have
earned / will earn a bachelor’s degree prior to July 1, 2020, and/or that you are planning to study
at the graduate or professional level during the 2020-21 year. To clarify your status, complete and
return this form to the Financial Aid Oce.
SECTION 1: Student Information
Name: _________________________________________ Student ID Number: ________________________
Address: ______________________________ City: _________________ State: _____ Zip: ______________
Primary Phone: ___________________________________
SECTION 2: Bachelor’s Degree Confirmation
Will you have your first bachelor’s degree before July 1, 2020?
Yes
No
If yes, complete the information on the college and degree below:
Name of college: _________________________________________________________________________
City/ State/Country where college is located: __________________________________________________
Month/Year Bachelor’s Degree received: ______________________________________________________
SECTION 3: Grade Level Confirmation
Will you be working on a graduate or professional degree during 2020-2021, meaning you are working
on a master’s or doctorate program during this current academic year? For example: MA, MBA, MD, JD,
PhD, EdD, or graduate certificate.
Yes
No
SECTION 4: Certification and Signature
I certify that all of the information on this form and accompanying documents are true and complete to
the best of my knowledge. Furthermore, I arm that I have not knowingly or intentionally provided any
false or fraudulent documentation.
Student Signature: ___________________________________________________ Date:
_______________
