2020-21 Custom - [V4]
Verification Worksheet (page 1 of 2)
Your Free Application for Federal Student Aid (FAFSA) was selected for ‘verification’. Federal regulations state that before awarding
Federal Student Aid, your school must verify the information you and your spouse (if married) reported on your FAFSA. To complete this
verification process, we will compare your FAFSA information with the information on this worksheet and other required documents. If
there are differences, we will make the appropriate corrections to your FAFSA. After we have reviewed your documents, we may request
additional information. If you have questions, please contact our office for assistance. Submit all requested documents to ‘CWC - ATTN:
Rustler Central’ by mail, deliver in person, email to records@cwc.edu or fax to 307-855-2092.
SECTION 1: STUDENT INFORMATION
STUDENT’S FULL NAME: SOCIAL SECURITY #: XXX XX -________ CWC ID #:
MAILING ADDRESS: CITY: STATE:_______ ZIP:
STUDENT’S DATE OF BIRTH: EMAIL ADDRESS: PHONE NUMBER:
MARITAL STATUS: _______________ (Single, Married / Remarried, Separated, Divorced, Widowed) DATE OF STATUS: _____________
HOUSING: I will live ON-CAMPUS I will live OFF-CAMPUS (on my own) I live with my PARENTS Live with: __________
WHAT IS YOUR COLLEGE HISTORY: I have never attended college I have attended CWC. I have attended the following colleges
(include names / dates):___________________________________________________________________________________________
Include any community college, university, vocational or technical and dual / concurrent credits taken while in high school. You will also need to order ‘official’ transcripts
from each of those schools / colleges to be sent directly to CWC.
SECTION 2: HIGH SCHOOL COMPLETION STATUS
Provide one of the following documents to indicate your high school completion status when you will begin college in 2020-21. If you are
not able to obtain the documentation listed below, please contact a Central Wyoming College financial aid staff member.
The student’s final official high school transcript with final GPA and graduation date is to be sent directly to Central Wyoming College,
ATTN: Rustler Central. This document can be delivered in a sealed envelope, mailed to CWC, emailed to records@cwc.edu or faxed to
307-855-2092 from the issuing institution.
Students who have received the equivalent of a high school diploma (GED Test scores, HiSET, TASC, or other State-authorized
examination) must submit their official test scores (not the certificate).
For a homeschooled student in a state where state law does not require the student to obtain a secondary school completion credential
for homeschool (other than a high school diploma or its recognized equivalent), a transcript or the equivalent, signed by the student’s
parent or guardian, that lists the secondary school courses the student completed and includes a statement that the student
successfully completed a secondary school education in a homeschool setting.
An academic official transcript that indicates the student successfully completed at least a two-year program that is acceptable for full
credit toward a bachelor’s degree.
Verification of my High School Completion (HS Transcript or GED Test Scores) has been submitted to Central Wyoming College.
Warning: If you purposely give false or misleading information on this worksheet, you will be reported to the Department of Education, you may be fined, sent to
prison or both.
SECTION 3: CERTIFICATIONS AND SIGNATURES
By signing this worksheet, I certify that all of the information reported on both pages of this worksheet is complete and correct. I also
understand that ALL required documents must be submitted before CWC can make any federal financial aid disbursements for 2020-21.
Student Signature Date
2020-21 Custom Verification Worksheet V4 (page 2 of 2)
Student’s Full Name: Student’s CWC ID #:
2 0 2 0 2 0 2 1 I D E N T I T Y A N D S T A T E M E N T O F E D U C A T I O N A L P U R P O S E
The student must appear in person at Central Wyoming College to 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. If
the student is unable to complete in person, then this statement must be completed in the presence of a Notary Public.
DO NOT COMPLETE THIS FORM IN ADVANCE
-------------------------------------------------------------------------------------------------------------------------------
Statement of Educational Purpose
I certify that I am the individual signing this Statement of Educational Purpose
(Print Student’s Name)
and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of
attending Central Wyoming College for 2020-2021.
Student Signature: _________________________________ Date: _______________ Student’s ID Number: _______________
IF SUBMITTING TO CWC IN PERSON
Present this form with original valid
government-issued photo ID, such as, but not
limited to, a driver’s license, other state issued
ID, or passport.
IF STUDENT IS UNABLE TO APPEAR IN PERSON - SUBMIT BY MAIL
Identity and Statement of Educational Purpose (To Be Signed in the
Presence of a Notary) to verify student’s identity, the student must
submit: 1) A copy of the unexpired valid government-issued photo
identification (ID) that is acknowledged in the notary statement below, or
that is presented to a notary, such as, but not limited to a driver’s license,
other state issued ID, or passport; and 2) The original Statement of
Educational Purpose provided above, which must be notarized. If the
notary statement appears on a separate page than the Statement of
Educational Purpose, there must be a clear indication that the Statement
of Educational Purpose was the document notarized.
Completed by CWC Official:
Completed by Notary Public:
ID Type:
State of: City/County of:
ID Number:
On (Date):
Expiration Date:
Before me (Notary’s Name):
Name of CWC Official:
Personal Appeared (Printed Name of Signer):
Signature of CWC Official:
And proved to me on basis of satisfactory evidence of identification (Type
of government-issued photo ID provided):
Date:
To be the above named person who signed the foregoing instrument.
Notary Signature:
WITNESS my hand and official seal:
(seal)
My commission expires on:_____________