CSCU Community College Consortium Agreement Request
Step 1: To be Completed by the student
Home School: Host School:
(Institute granting student’s degree or certificate) (Institute student is visiting to take courses)
Address: Address:
The scho
ols above are herein entering into a Consortium Agreement for (print legibly, please):
Name:
Student ID
: @
Academic Program:
Phone: (
)
Email:
Special instructions to the student:
The student must:
Be enrolled in an eligible degree or certificate program; must have been approved for financial aid and be making
satisfactory academic progress at your Home School during the semester you are applying for this agreement.
Take only a course(s) at the Host School that is (are) required for the completion of your certificate or degree program
at your Home School. Courses must be approved by your Home School Advisor.
Submit a grade transcript from the Host School to your Home School Registrar’s Office upon completion.
You are responsible for purchasing any books associated with courses covered by this agreement. Books are not
covered by financial aid under this agreement.
Be aware that financial aid is awarded and disbursed by your Home School only.
Please be advised that the Host School may require payment of tuition and/or fees from you at the time of registration
regardless of your financial aid status. If this request is submitted late, you must pay the Host School.
The Home School will make every effort to transfer the funds directly to the Host School. However, if the Host School
does not bill, or bills late, the Home School will disburse the award directly to the student, and the student will be
responsible for paying the Host School directly. If the eventual aid award is insufficient to cover all costs, the student
will be responsible for all remaining expenses due to the Home and/or Host School.
Student Signature: Date:
Year Fall
Spring Summer
Course(
s) student will be enrolled in at HOME SCHOOL
:
Course Title
Course #
# of Credits
Course(
s) student will be enrolled in at HOST SCHOOL
:
Course Title
Course #
# of Credits
Rev. 03/31/20
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CSCU Community College Consortium Agreement Request
I certify that the course(s) listed above are required to fulfill degree/certificate requirements at the Home School.
Authoriz
ed Signature of HOME School Official:
Signature Print Name & Telephone Date
Step 2: To
be Completed by the Home School Financial Aid Office
The Consortium Agreement will allow the Home School to disburse financial aid based on the student’s
combined enrollment at both institutions. The Home School is responsible for determining financial aid
eligibility, awards, disbursing aid, returns, monitoring Satisfactory Academic Progress and reporting
requirements for institutional, state, and federal aid. The Home School will seek to verify enrollment at the
Host School during the period of enrollment, and will also seek final grades for the student at the conclusion of
The Home
School will process financial aid according to the method below:
School for the direct charges itemized by the Host School. The student shall be responsible for paying any
difference in tuition and fee charges. The student is responsible for the purchase of their books at the Host
Estimated F
inancial Aid Funds to be transferred by Home School:
Estimated
Out-of-Pocket Book/Supply Costs to the Student:
Step 3: To
be completed by the Host School Financial Aid Office (or attach Registration Form):
Period of Enrollment and Registered Courses:
Year Fall Spring
Summer
Courses f
or which the student is registered:
Course Title
Method of Class Delivery (select type)
Course #
# of Credits
Cost for Total Credits: Tuition: Fees:
Total:
NOTE: The Host School will notify the Home School if the Student withdraws from any of the above co
urses at any
time during the enrollment period.
HomeSchool
Authorized Official:
Print Name & Telephone:
HostSchool
Authorized Official:
Print Name & Telephone:
Date:
Date:
$ 0.00
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