Section III
Under this consortium agreement, the Host School (Name): ________________________________
Certifies the number of credit hours the student is taking: _______ Cost per hour $ __________
Student’s enrollment status while at the Host School: Full Time Three-quarter time Half Time Less than half time
Course # Course Title Credits __ | Course # Course Title _________Credits_______
__________________________________________|_____________________________________________________
__________________________________________|_____________________________________________________
Enrollment period dates: __________________________ to _____________________________
Will the student receive any financial aid at your institution? Yes No
T
ype and amount of funding from Host School: ______________________ $_______________
______________________ $_______________
Full time budget at the Host school:
T
uition and Fees: $________________ Books and Supplies: $___________________
Room and Board: $________________ Transportation: $___________________
Under t
his consortium agreement, the Host School:
1. Certifies that the student listed has been accepted for enrollment in an academic program that meets the Title IV student financial aid
eligibility requirements.
2. Will provide the University of Kentucky with documentation of the student’s enrollment.
3. Agrees to notify the University of Kentucky if the student fails to enroll in, or withdraw from, the Host School (to include the withdrawal
date and other relevant information).
4. Will provide the University of Kentucky with an academic transcript upon completion of consortium period when requested by the student.
5. Our institution is approved by the Department of Education to participate in Title IV programs.
Host School Financial Aid Officer’s Signature: _____________________________________ Date: _______________
Printed Name: _________________________________ Title: ___________________________ Title IV school code: ___________
E-mail Address: ________________________________ Telephone: __________________________
Section IV
Under this consortium agreement, the University of Kentucky:
1. Agrees to process the student’s Title IV financial aid application and provide payment of Title IV funds (if eligible) as appropriate for the
consortium period.
2. Will make available applicable student consumer information required under Title IV.
3. Certifies that the student is making satisfactory academic progress toward the completion of his or her degree, certificate, or recognized
credential at the University of Kentucky.
4. Will calculate returns of Title IV funds, when appropriate.
5. Will maintain Title IV record keeping and reporting requirements.
6. Certifies that the student is enrolled in a degree, certificate, or recognized credential at the University of Kentucky.
7. Agrees to accept the course work listed above toward the completion of the student’s degree, certificate, or other recognized credential
requirements.
University of Kentucky Financial Aid Officer’s Signature: ___________________________________
Printed Name:________________________________________ Date: _________________________
E-mail Address: ____________________________
Telephone: (859) 257-3172 Fax number: (859) 257-4398
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