2020-2021
Statement of Educational Purpose
Identity and Statement of Educational Purpose
(To Be Signed at the Institution
in the presence of
a Financial Aid Representative)
The student must appear in person at Klamath Community College (KCC) verify his
or her identity by
presenting an unexpired 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 the student’s
photo ID that is annotated by the institution with the date it was received and reviewed, and the name of
the official at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the Statement of
Educational Purpose provided below.
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 Klamath
Community College (KCC) for 2020–2021.
________________ _____________________________________ _________
(Student’s Signature) (Date)
____________________________ ____________________________
(Student’s ID Number) (Student’s SS Number)
Received by: ___________________________________ Date: __________________
Financial Aid Administrator (Print Name)
WARNING: If you purposely provide false or misleading information you may be fined, be sentenced to jail, or both.
For Financial Aid Office Use Only
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signature
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