Financial Aid Office
2020-21 Proof of Residence
Complete this form, sign, date and drop off at Financial Aid office, SSC L177, mail to Manchester Community College, Financial Aid Office, Great Path, MS #11, P.O. Box
1046, Manchester, CT 06045-1046, or fax to 860-512-3381. For more information, contact the Financial Aid office at 860-512-3380.
First Name MI Last Name Banner ID Number
Student Name
I,
hereby certify that I currently reside at the following address:
Street Address
City State Zip
I also acknowledge that I do not reside with my parent(s) and their address is:
Street Address
City State Zip
I am also attaching a copy of my proof of residence along with proof of my parents’ residence.
*Acceptable forms of documentation include, but are not limited to, lease agreement, mortgage statement, current electric/gas bill, etc.
Student Signature Date
March 2020/PR
FOR OFFICE USE ONLY
Date Received _______/_______/__________ Reviewed By ______________________________