Page 1 of 2
OFFICE OF FINANCIAL AID
Student Community Center, Rm 210
Phone: 973-328-5230 | Fax: 973-328-5237
Email: finaid@ccm.edu
Attention: This form is applicable per term to CCOG eligible students only and based on their initial eligibility as per NJ Higher Education Student
Assistance Authority (HESAA) for which eligibility is subject to change or cancellation due to corrections (if any) and is not applicable to other awards.
CCOG Hardship - Attendance Waiver Form
(Non-Morris County Resident use only)
Student Name
(LFM)
CCM ID#
Address
Phone or Email
CCM Academic Major
Current Term and Registered Credits
SECTION A:
SEMESTERS YOU PLAN TO ENROLL AT COUNTY COLLEGE OF MORRIS
Fall
Spring
REASON(S) REQUESTING CCOG HARDSHIP - ATTENDANCE OUT OF COUNTY WAIVER APPROVAL (CHECK ONE)
(Submit proof with this form (Example: Location of employment, W2 or Paystub; Admission counselor statement))
Home county college cannot admit the students into the desired program of study due to lack of available space,
which will exist for at least one year
Proximity of the student’s residence or place of employment to the out-of-county institution
Place of Student’s Employment
or Student’s Residence
Distance from Home
County College
Distance from
County College of Morris
(CCM)
employment related request)
It is a hardship to attend the home county college for other reasons. Describe Hardship:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Important: This form is only pertaining to the Community College Opportunity Grant (CCOG) eligibility and does not replace any of the existing
Chargeback policies and procedures at any institutions. This form is not applicable for in county tuition rates. Note: Reasons referenced above as per NJ
HESAA CCOG- PP. https://www.hesaa.org/Documents/CCOG/CCOGPolicies.pdf, pg.3;para (c).
CERTIFICATION:
I certify that I understand the information above and all information given is true and complete to the best of my knowledge. I further agree to
submit proof of the information that I have provided above, understanding that if I do not submit requested documentation my request will be
denied. In addition to understanding that if awarded CCOG, that amount is subject to reduction or cancellation based on course(s) withdrawal,
corrections made to my initial FAFSA or New Jersey Alternative Financial Aid Application
results and that I am responsible for paying the difference.
S
tudent Signature: _________________________________________________________ Date: ____________________
Academic Year: __________
Page 2 of 2
Student Name
CCM ID#
SECTION B:
Completed by HOME COUNTY COLLEGE REPRESENTATIVE
CCOG Hardship - Attendance Waiver Decision
Home County College Information:
Approved Student is hereby released by their home county college, and can attend CCM at the out-of-county
tuition rate and is eligible to receive CCOG based on the above listed reason(s) in Section A.
Denied Student must attend their Home County College to receive CCOG or submit an approved
Charge-Back for CCOG eligibility review.
Reason if Denied
Name of Institution:
Street Address:
City:
State:
Zip:
County:
Name and Title of Home County Representative completing this section:
Name:
Title:
Email:
Contact number:
Authorized Signature:
Date:
~~ Reminder: Submit documented proof of reason indicated above with this form to County College of Morris. ~~
SECTION C:
Accepted …. In agreement with the student’s hardship claim and resident County College approval for CCOG
Rejected …. Reason: In sufficient proof | Proof not received | Other ______________________________
Authorized Signature: ________________________________________________ Date: ____________
CCMFAA.REV. 11/25/19
STUDENT RESIDENT HOME COUNTY COLLEGE SECTION Only:
County College of Morris (Out of County) - Financial Aid Office use only:
Print and Sign
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome