937.328.6034 | ﬁnancialaid@clarkstate.edu | 570 East Leel Lane, Springﬁeld, Ohio 45505
Unusual Enrollment History
The U.S. Department of Education has established regulations to prevent fraud and abuse in the
Federal Student Aid program by identifying students with unusual enrollment histories. Some
students who have an unusual enrollment history have legitimate reasons for their enrollment
at multiple institutions. However, such an enrollment history requires our oce to review your
ﬁle in order to determine future federal ﬁnancial aid eligibility. If selected by the Department of
Education, this must be resolved before you will receive ﬁnancial aid.
SECTION A: Student Information
Name____________________________________________ Student ID Number___________________
Street City State Zip
Home Phone __________________________________ Work Phone _____________________________
SECTION B: Schools Attended
Processing for Unusual Enrollment History cannot begin until a completed form and all academic
transcripts (if applicable) are received.
• Please list all colleges attended during the time frame listed below, including the Clark State
Community College. If you attended multiple schools during the indicated time frame, attach an
additional page listing all schools you attended and include your name and Student ID at the top of
each page. If you have attended Clark State Community College during any of these years, you are
required to list Clark State Community College.
• You must attach an academic transcript (ocial or unocial) from each college attended. Please
note: if any unocial transcripts are unclear you will be required to provide ocial academic
transcripts. Failure to report all colleges with attached transcripts will result in denial of your
request for ﬁnancial aid at Clark State Community College.
Name of College Dates Attended Did you earn credit hours?
FAC20UEH or FAC20VEH