Fillable 2021-2022 Custom Verification V4 Worksheet Financial Aid Office (Eastern Wyoming College)

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2021-2022 Custom Verification V4 Worksheet Financial Aid Office (Eastern Wyoming College)

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The 2021-2022 Custom Verification V4 Worksheet Financial Aid Office (Eastern Wyoming College) form is 2 pages long and contains:

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  • 6 check-boxes
  • 16 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Eastern Wyoming College

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Hand deliver or mail original:
Financial Aid Office
Eastern Wyoming College
3200 West C Street
Torrington, WY 82240
HIGH SCHOOL COMPLETION STATUS
2021-2022
Custom Verification
V4 Worksheet
Your application has been selected for review in a process called “Verification.” The Statement of Educational Purpose must be
signed in ink in person with a Financial Aid Office Administrator, EWC Outreach Coordinator, or Notary Public. Your
completed worksheet with ink signature must be hand-delivered or mailed to the Financial Aid Office at EWC. Copies not accepted.
___________________________________________________________ ____________________ __________________________
Last Name First Name M.I. EWC Student ID Number Social Security Number (last four digits)
___________________________________________________________ _______________________________________________
Mailing Address (include apartment number) E-mail Address
___________________________________________________________ _______________________________________________
City, ST, Zip Phone Number (include area code)
Please provide ONE of the following documents that indicates what your high school completion status will be when you will begin
college in 2021-2022. Submit it with this form and any other documentation requested.
A copy of your high school diploma.
Your final official high school transcript that shows the date when the diploma was awarded.
An official State certificate or transcript of passing a State-authorized examination that the State recognizes as the equivalent
of a high school diploma (GED, HiSET, TASC, or other State-authorized examination).
An official academic transcript that indicates you successfully completed at least a two-year program that is acceptable for full
credit toward a bachelor’s degree.
Please note: Credits transferred in from previous institutions attended may affect your maximum time frame calculation as defined
in EWC’s Satisfactory Academic Progress Policy.
If you were home schooled in Wyoming, a copy of your transcript or the equivalent, signed by a parent or guardian.
If you were home schooled in another state and your state requires home schooled students to obtain a secondary school
completion credential for home school (other than a high school diploma or its recognized equivalent), a copy of that credential.
If you are unable to obtain any of the forms of documentation listed above, please contact the Financial Aid Office.
By signing this worksheet, I certify that all of the information is complete and correct. I have read and agree to comply with all
verification policies as stated by EWC in the College Catalog and on the EWC website. Failure to submit information in a timely
fashion may result in the application being filed as inactive with no further consideration and no federal aid for the academic year.
Student must sign:
____________________________________________________________________________________________________________
Student’s signature Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
STUDENT INFORMATION
CERTIFICATION AND SIGNATURE
Over
2021-2022 IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE
The student must apply in person at Eastern 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 collect the student’s ID.
In addition, the student MUST sign, in the presence of an institutional official, the Statement of Educational Purpose provided
below. If the student is unable to appear in person at EWC to verify his or her identity, the student must provide to the institution:
(a) 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
(b) The original Statement of Educational Purpose provided below, 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.
DO NOT COMPLETE THIS FORM IN ADVANCE.
Statement of Educational Purpose
I certify that I __________________________________________________ am the individual signing this
(print student’s name)
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 Eastern Wyoming College for 2021-2022.
Student signature:
Date: Student ID #:
Declaración de Propósito Educativo
Certifico que yo, __________________________________________________ soy el individuo que firma esta
(Imprimir Nombre del Estudiante)
Declaración de de Propósito Educativo, y que la ayuda financiera federal estudiantil que yo pueda recibir, sólo
será utilizada para fines educativos y para pagar el costo de asistir a Eastern Wyoming College para 2021-2022.
Firma del estudiante:
Fecha: __________________________ Número de identificaciôn del estudiante:___________________
IF SUBMITTING 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 SUBMITTING BY MAIL
Submit this original notarized form with photocopy of valid
government-issued photo ID to EWC.
To be completed by EWC Financial Aid Administrator
or EWC Outreach Coordinator (FAA/OC):
To be completed by Notary Public:
ID Type:
State of: City/County of:
ID Number:
Exp:
On (date):
Before me:
(notary’s name)
FAA/OC Name:
Personally appeared (printed name of signer):
FAA/OC Title/location:
On basis of satisfactory evidence of identification:
(Type of government-issued photo ID provided)
FAA/OC Signature:
Date:
To be the above-named person who signed the
foregoing instrument.
Notary signature:
WITNESS my hand and official seal:
My commission expires on: ________________________
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2021-2022 Custom Verification V4 Worksheet Financial Aid Office (Eastern Wyoming College)

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Completed 4 February 2021

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