2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
________________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17209
Page 1 of 11
Instructions for Completing the Soka International Student Financial Aid Application
This form should be completed by international non-U.S. undergraduate resident students applying to
Soka University, for classes beginning in the Fall of 2021, who are applying for any financial aid.
Collect the following documentation to assist with completing this application:
o Tax Returns and Income Documentation:
Non-U.S. tax returns Must show ‘Total Income’ and ‘Total Tax Assessed’ amounts.
U.S. tax returns This includes tax transcripts, IRS Form 1040NR, or IRS Form 1040.
For non-tax return filers Income documentation that shows ‘Total Income’.
NOTE: ‘Income’ and ‘Tax Assessed’ figures should include the entire 12-month “2019 tax
period. The United States 2019 tax period is January 1, 2019 to December 31, 2019. If
you or your parents filed taxes in a country that uses a “fiscal” tax period (such as July 1,
2018 to June 30, 2019), use/submit income and tax documents for both the 2018-2019
and 2019-2020 fiscal years; to include all 2019 income.
o Bank, Brokerage, and Investment Account Statements. Do not include “retirement” accounts.
o Investment Real Estate or Business(es) owned by you or your parents.
o Grant and Scholarship Documentation
o Any other miscellaneous funds earned by, or paid to, you or your parents.
All non-English language documents must be submitted in English-translated form and include an official
translation certification form.
All monetary values must be submitted in both their local currency value and US dollar conversion value.
Complete all application sections. Do not leave a question or amount response blank. If a question does
not apply, use N/A(Not Applicable) where a response is requested, or use 0if an amount is requested.
Forms submitted with blanks will be considered incomplete and may delay receipt of financial aid.
Submit additional sheets along with this application if more room is required to answer any question.
Do not submit this cover page along with your application.
Students previously admitted to SUA should include their seven-digit “SUA Student ID#” on this form. First-
time SUA applicants will not have an SUA ID# and should leave this field blank.
NOTE: Soka University of America may request additional supporting documentation for any information
or monetary figure submitted on this form.
You must submit your completed application, along with all required supporting
documents, via mail or in-person, by the following deadline!
Application Submission Deadlines
Incoming (First-Year) Students:
February 15, 2021
Continuing Students:
March 2, 2021
WARNING!: Late application or documentation submissions will result in a reduction of grants or scholarships.
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Name (Last, First, MI): ___________________________________________ SUA Student ID#: _______________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 10/2/20
Page 2 of 11
Please use the appropriate conversion rate listed below when calculating all non-U.S. dollar monetary values in
this application. Use this same currency rate when having your financial documents professionally translated. If
you do not see your country listed, please contact the Soka Office of Financial Aid for the proper conversion rate.
The Soka Office of Financial Aid reserves the right to refuse documents that use different conversion rates.
Country
Currency
USD
Exchange Rate
Country
Currency
USD
Exchange Rate
Afghanistan
AFN
$1
77.0125
Myanmar
MMK
$1
1295.96
Albania
ALL
$1
105.602
Nepal
NPR
$1
117.675
Argentina
ARS
$1
76.2430
Netherlands
EUR
$1
0.8514
Australia
AUD
$1
1.39147
New Zealand
NZD
$1
1.5044
Bangladesh
BDT
$1
84.6822
Nigeria
NGN
$1
381.461
Bosnia and Herzegovina
BAM
$1
1.66504
Pakistan
PKR
$1
165.069
Brazil
BRL
$1
5.6409
Peru
PEN
$1
3.605
Bulgaria
BGN
$1
1.66507
Philippines
PHP
$1
48.479
Cambodia
KHR
$1
4099.36
Poland
PLN
$1
3.8158
Cameroon
XAF
$1
558.442
Russia
RUB
$1
77.4991
Canada
CAD
$1
1.32906
Rwanda
RWF
$1
974.691
Caribbean
XCD
$1
2.70239
Singapore
SGD
$1
1.36301
China
CNY
$1
6.7905
South Africa
ZAR
$1
16.6432
Congo (Kinshasa)
CDF
$1
1952.34
South Korea
KRW
$1
1163.1
Denmark
DKK
$1
6.33738
Spain
EUR
$1
0.8514
Egypt
EGP
$1
15.7449
Sri Lanka
LKR
$1
184.853
Ethiopia
ETB
$1
36.7191
Sweden
SEK
$1
8.9217
France
EUR
$1
0.8514
Switzerland
CHF
$1
0.9187
Georgia
GEL
$1
3.2189
Taiwan
TWD
$1
28.883
Germany
EUR
$1
0.8514
Tajikistan
TJS
$1
10.3238
Ghana
GHS
$1
5.7917
Thailand
THB
$1
31.5611
India
INR
$1
73.208
The Gambia
GMD
$1
51.7837
Indonesia
IDR
$1
14838.8
Tunisia
TND
$1
2.744
Italy
EUR
$1
0.8514
Turkey
TRY
$1
7.739
Japan
JPY
$1
105.542
Uganda
UGX
$1
3710.07
Kenya
KES
$1
108.448
Ukraine
UAH
$1
28.3714
Liberia
LRD
$1
198.849
United Arab Emirates
AED
$1
3.6725
Malawi
MWK
$1
749.874
United Kingdom
GBP
$1
0.77566
Malaysia
MYR
$1
4.150
Vietnam
VND
$1
23144.84
Mexico
MXN
$1
21.8959
Zambia
ZMW
$1
20.0453
Mongolia
MNT
$1
2860.8
Zimbabwe
ZWD
$1
361.9
Morocco
MAD
$1
9.2472
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 3 of 11
SECTION A: DEMOGRAPHIC INFORMATION
Complete all application sections and fields leaving no question or amount response blank. If a question does not apply, write “N/A” (Not Applicable) where
a response is requested, or 0” if an amount is requested. Forms submitted with blanks will be considered incomplete and may delay receipt of financial aid.
PART A1: STUDENT INFORMATION
Name (Last, First, MI): __________________________________________ SUA Student ID#: __________________
Phone Number: _____________________________ Date of Birth: ___________________________________
*Country of Citizenship: ______________________ Email Address: __________________________________
* NOTE: If you are a US citizen or a permanent resident, STOP HERE. You must apply to SUA as a Domestic Student.
Marital Status: Single Married **Separated **Divorced Widowed
** Date of Separation (if Separated or Divorced): ___________________
PART A2: PARENT INFORMATION
NOTE!: If you (the student) were born before January 1, 1998, or are legally married, you are an
“independent” student and may skip all parental information questions on this entire form.
The term parent” refers to a biological parent, adoptive parent, or step-parent. If your parents are married
or not married & living together, list the names of both parents, even if one is not working. If you live with
one parent who has re-married, list the name of your biological parent and your step-parent. If your parents
are divorced or separated, and not living in the same household, list only the parent you lived with more
during the past 12 months.
Parent 1 Name: _____________________________________________________________________
Parent 2 Name: _____________________________________________________________________
Parents’ Current Marital Status
Single Married Re-Married **Separated **Divorced Widowed
*Date of Separation (if Separated or Divorced): __________________
Dislocated Workers/Displaced Homemakers
As of today, are either of your parents a “dislocated worker” or “displaced homemaker?” Yes No
(A person is considered “dislocated” if he/she meets one of the following conditions: (a) has lost his/her job, (b) has been laid off, (c) is
receiving unemployment benefits due to layoff, (d) was self-employed, but is now unemployed due to economic conditions or natural
disasters.) (Verification documentation may be requested.)
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 4 of 11
PART A3: FAMILY HOUSEHOLD INFORMATION
List the people living in your parent(s)’ household. Please include:
Yourself (even if you do not live with your parents); and your parent(s) {including a step-parent}.
o If your parents are divorced or separated, include the parent that lives in the household.
Your parent(s)’ other dependent children, even if not living with your parent(s). List only family members
your parent(s) provide more than half of their support for, OR family members that would be required to
provide your parent(s)’ information when applying for student aid. Do not include foster children.
Other members; only if: (a) they live with your parent(s), AND (b) your parent(s) provide more than half
of their support, AND (c) they will continue to provide support from July 1, 2021 through June 30, 2022.
College information for any household member that: (a) will enroll in college at least half-time during the
2021-2022 academic year, AND (b) was born on or after January 1, 1998, AND (c) will be enrolled in an
undergraduate degree, diploma, or certificate.
Full Name of Household
Member
Relation to
Student
Born on or
after January
1, 1998
Information for family members born on or
after January 1, 1998; who will enroll at least
half-time in college during 2021-2022*
Name of College
Type of
Degree
(BA, MA, etc.)
Year in College
for 2021-2022
(1, 2, 3, or 4)
Yourself
N/A
Soka University
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
* Verification of college enrollment may be requested from you at a later date. Please note that we will not consider college enrollment for: (a) parents, (b)
foster children, or (c) family members attending a foreign college, a military school, a non-financial aid recipient college, or those enrolled in
graduate/professional schools.
If any member of your household (listed in the previous table) is NOT a parent or brother/sister,
please explain how and why your family is financially supporting this person:
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 5 of 11
SECTION B: INCOME AND TAX INFORMATION
Complete all application sections and fields leaving no question or amount response blank. If a question does not apply, write “N/A” (Not Applicable) where
a response is requested, or 0” if an amount is requested. Forms submitted with blanks will be considered incomplete and may delay receipt of financial aid.
PART B1: TAX RETURN NON-FILERS (Did not file ANY tax returns, in any country.)
PART B2: TAX RETURN FILERS (Filed a tax return in a country other than the United States.)
Answer the following questions regarding non-U.S. tax return filings for non-U.S. income earned or gained.
2019 Tax Return Non-Filer Information
STUDENT
PARENT 1
PARENT 2
For each person listed, check only one box for
either Question 1 or Question 2, but not both!
1) Check the box for any person that did not earn ANY income in 2019.
2) Check the box for any person that did earn income in 2019, and was
not required to file a 2019 tax return.
FOR ALL PERSONS WITH BOXES CHECKED FOR QUESTION #2 ABOVE:
If they worked in the U.S.: Attach IRS Form W-2 for all sources of income. For any sources of income for
which they do not have an IRS Form W-2, please attach a signed statement listing these sources of income, the
amounts earned from each source, and an explanation of why they are unable to provide a W-2 form.
If they worked outside of the U.S.: Attach income statement forms for all sources of income. For any
sources of income for which they do not have an official statement of income, please attach a signed
statement listing these sources of income, the amounts earned from each source, and an explanation of why
they are unable to provide an official statement of income form. Provide monetary values in both U.S dollars
and local currency amounts using the currency conversion information from the chart on Page 2.
2019 Non-U.S. Tax Return Filer Information
STUDENT
PARENT 1
PARENT 2
Check the box for any person that filed a non-U.S. tax return for
the 2019 tax year. If your home country is on a fiscal year, and not
on a calendar tax year, use both the 2018-2019 and 2019-2020 tax
years.
FOR ALL PERSONS WITH BOXES CHECKED IN THE QUESTION ABOVE:
1. Attach all original tax documents. Include a signed, translated, notarized copy of each tax document.
2. Tax document submissions must have all monetary figures converted to U.S. dollars using the currency
conversion rates listed in the chart on Page 2. Currency conversion information (symbol, rate, & date)
must be clearly stated.
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 6 of 11
PART B2: TAX RETURN FILERS, continued (Filed a U. S. tax return for non-residents of the U. S.)
Answer the following questions for any non-U.S resident that filed a U.S. IRS 1040NR tax form.
PART B3: TOTAL INCOME & TOTAL TAX ASSESSED
Enter the Total Income & Total Tax Assessed values into the table below by adding the figures obtained from
forms gathered in sections PART B1 and PART B2.
The figures entered below should represent income totals, regardless of income origin.
Be sure to list totals in both ‘Home Currency’ and ‘U.S. Dollars’ using the currency conversion chart on Page 2. If
income was earned in the U.S., enter “N/A” in the ‘Home Currency’ column.
* NOTE: ‘Income’ and ‘Tax Assessed’ figures should include the entire 12-month “2019 tax period. The United States 2019
tax period is January 1, 2019 to December 31, 2019. If you or your parents filed taxes in a country that uses a “fiscal” tax
period (such as July 1, 2018 to June 30, 2019), use/submit income and tax documents for both the 2018-2019 and 2019-2020
fiscal years; to include all 2019 income.
2019 U.S. IRS 1040NR Tax Filer Information
STUDENT
PARENT 1
PARENT 2
Check the box for any person that filed, or will file, a U.S. IRS
1040NR tax return (U.S. Non-Resident Alien Income) for the 2019
tax year.
FOR ALL PERSONS WITH BOXES CHECKED FOR THE QUESTION ABOVE:
Attach an official copy of any completed tax form, or an official tax transcript, and submit with this application.
2019 Total Income & Total Tax Assessed Information
List the following totals for any
person who earned any income
in 2019 (*see NOTE below)
Home Currency
U.S. Dollars
FOR SCHOOL USE ONLY
(Home/US)
STUDENT
Total Income
Total Tax Assessed
PARENT 1
Total Income
Total Tax Assessed
PARENT 2
Total Income
Total Tax Assessed
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 7 of 11
PART B4: UNTAXED INCOME INFORMATION
2019 Untaxed Additional Income Information
STUDENT
PARENT(S)
Totals from 1/1/19 to 12/31/19
(U.S. dollars)
List the ‘Total Child Support received for any of your children. Do not
include foster children.
List the total of housing, food, and other living allowances paid to any
members of the military, clergy, or others (including cash payments and
cash value of benefits). Do not include the value of on-base military
housing or the value of a basic military allowance for housing.
List the total of any other money you or your parents received on your
behalf that is not reported elsewhere on this form. (e.g., bills paid for
you, etc.)
PART B5: ADDITIONAL FINANCIAL INFORMATION
2019 Additional Financial Information
List the ‘Total Child Support’ paid out because of divorce or separation. Do not include support for family members listed
in the table located in the PART A3: FAMILY INFORMATION section of this form.
Full Name of Person Who
Paid Child Support
Full Name of Child for
Whom Support was Paid
Age of
Child
Full Name of Person to
Whom Support was Paid
Total Paid
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 8 of 11
SECTION C: BANK ACCOUNTS, INVESTMENTS, & ASSETS
Complete all application sections and fields leaving no question or amount response blank. If a question does not apply, write “N/A” (Not Applicable) where
a response is requested, or 0” if an amount is requested. Forms submitted with blanks will be considered incomplete and may delay receipt of financial aid.
Please provide information for all accounts and assets held by you and/or your parents.
Calculate ‘Home Currency’ and/or ‘U.S. Dollar’ balances using the currency conversion chart on Page 2.
PART C1: ACCOUNT BALANCES AND NET WORTH
List total account balance information for yourself and your parents, as of the date of this application.
Be sure to check the appropriate box for any person who does NOT hold an account.
NOTE: SUA may request copies of statements for verification of balances for any account listed.
Accounts to include: Bank accounts (checking, savings, etc.), Brokerage (investment) accounts, Trust funds, UGMA and
UTMA accounts, Money market funds, Mutual funds, Certificates of deposit, Stocks, Stock options, Bonds, Other securities,
Installment and Land sale contracts, Commodities, etc. Include the value of all qualified education accounts such as
Coverdell savings accounts, 529 college savings plans, and Refund values of 529 pre-paid tuition plans.
Accounts to exclude: Life insurance policies, Designated retirement plans (e.g., 401k, 403b, Pension funds, Annuities, Non-
education IRAs, etc.)
Bank (Checking & Savings) and Brokerage (Investment) Account Balance Information
Provide the TOTAL BALANCE for every account held at any domestic or international institution.
Figures entered below should represent account balances as of the date of this application.
Owner
Check if this
person has
no accounts.
Account Type
(Bank, Brokerage, etc.)
Home
Currency
Balance
U.S. Dollars
Balance
FOR SCHOOL USE ONLY
(Home/US)
STUDENT
STUDENT
STUDENT
STUDENT
PARENT 1
PARENT 1
PARENT 1
PARENT 1
PARENT 2
PARENT 2
PARENT 2
PARENT 2
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 9 of 11
PART C2: INVESTMENT REAL ESTATE
IMPORTANT!: DO NOT include the primary residence that you or your parents live in on a daily basis.
Provide details for all investment real estate held by you or your parents. Attach additional sheets if needed.
“Investment Real Estate” includes: Real estate other than your primary residence, rental properties, mobile homes,
condominiums, duplexes, land, summer homes, etc.
PART C3: BUSINESS INFORMATION
Provide information for any businesses or investment farms owned by you or your parents.
Do not include businesses with 100 or fewer full-time employees, or designated family farms.
Documents will be sent to you requesting further information. Attach additional sheets if needed.
Investment Real Estate Information
PROPERTY #1
Property Address
Held By
Student
Parent
Original Purchase Price (USD)
Current Market Value (USD)
Current Mortgage Loan Balance (USD)
Investment Real Estate Information
PROPERTY #2
Property Address
Held By
Student
Parent
Original Purchase Price (USD)
Current Market Value (USD)
Current Mortgage Loan Balance (USD)
Business or Investment Farm Information
BUSINESS #1
Business Address
Business Name & Nature
Held By
Student
Parent
Percent of Ownership Interest
Business Market Value (USD)
(100% value, not % of ownership)
Business Debt (USD)
(100% debt amount, not % of ownership)
Number of Full-time Employees
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 10 of 11
SECTION D: OUTSIDE FUNDING
Complete all application sections and fields leaving no question or amount response blank. If a question does not apply, write “N/A” (Not Applicable) where
a response is requested, or 0if an amount is requested. Forms submitted with blanks will be considered incomplete and may delay receipt of financial
aid.
List ANY outside funding that has been paid, or that will be paid, directly to you for the upcoming 2021-2022
academic year in the form of a scholarship, grant, or loan.
For each item listed below, submit documentation providing details for the funding.
IMPORTANT NOTE: If you receive notification of ANY additional Outside Funding after submitting this
application, you are required to immediately notify the SUA Office of Financial Aid.
2021-2022 School Year - Outside Funding Information
Name and Source of Funding
Type of Funding
Amount of Funding
(U.S. dollars)
Example: Japanese Student Services Organization (JASSO)
Grant
Loan
$25,000
Scholarship
Grant
Loan
Scholarship
Grant
Loan
Scholarship
Grant
Loan
Scholarship
Grant
Loan
Scholarship
2021-2022 International
Undergraduate Student
Financial Aid Application
(APPL)
Office of Financial Aid
Name (Last, First, MI): ___________________________________________
SUA Student ID#: _______________
___________________________________________________________________________________________________________
SOKA UNIVERSITY OF AMERICA OFFICE OF FINANCIAL AID 1 UNIVERSITY DRIVE ALISO VIEJO, CA 92656
www.soka.edu/financialaid financialaid@soka.edu P: (949) 480-4342 F: (949) 480-4151
Updated: 9/17/20
Page 11 of 11
SECTION E: SUBMISSION INFORMATION
1) If you are a current Soka student, or an admitted Soka applicant, please review all
“To Do List” items for incomplete items or missing documents at:
http://learn.soka.edu
Locate the “To Do List” section on the right of the screen.
Click the ‘more’ link to display an extended list of your To Do List items.
Incomplete documents will display with a status of “Initiated” or “Notified”.
2) Return this completed form to the Soka University Office of Financial Aid.
Please mail this form, or deliver this form in-person, along with include any supporting documents.
If you choose to submit information via email, SUA will not be responsible for any data security breach, and we
may still request that you submit original documents.
Applications can be mailed or delivered in-person to:
Soka University of America
Attn: Office of Financial Aid
Founders Hall, Room 216
1 University Drive
Aliso Viejo, CA 92656
USA
Website: www.soka.edu/financialaid
Email: financialaid@soka.edu
Phone: (949) 480-4342
For more information, please visit our website at: www.soka.edu/financialaid
SECTION F: SIGNATURE(S)
By signing this form, we certify that all the information reported on this application is complete and accurate to the best of our knowledge. Some
information may be an estimate and will be confirmed and/or updated by the submission of verification documents (i.e., tax returns, bank statements, etc.)
I understand that any false statements or misrepresentation may be cause for denial, reduction, withdrawal, and/or repayment of financial aid, and that I
may be subject to a fine. (If you were born before January 1, 1998; your parents do not need to sign this form.)
(This form requires handwritten signatures. Photocopies of handwritten signatures are permitted. Electronic, or typed, signatures will not be accepted.)
___________________________________ __________________________________________________ _________________
Student Name (print) Student Signature (hand-written signature only, see note above) Date
___________________________________ __________________________________________________ _________________
Parent Name (print) Parent Signature (hand-written signature only, see note above) Date