Fillable DRUG CONVICTION ELIGIBILITY WORKSHEET FOR 2021-2022 Complete this (State University of New York at Plattsburgh)

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DRUG CONVICTION ELIGIBILITY WORKSHEET FOR 2021-2022 Complete this (State University of New York at Plattsburgh)

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R
evised: 12/01/2019 DRUGIN
Financial Aid Office • SUNY Plattsburgh • 101 Broad Street • Plattsburgh, NY 12901-2681
Tel: (518) 564-2072 • Toll-Free: (877) 768-5976 • Fax: (518) 564-4079 • email: finaid@plattsburgh.edu
DRUG CONVICTION ELIGIBILITY WORKSHEET FOR 2021-2022
Student Name: ___________________________ Banner ID or NetID: ____________________________
Complete this worksheet if you left the drug conviction question on your FAFSA blank, or if you indicated that
you have a drug-related conviction on your FAFSA. Count only federal or state convictions for the possession
or sale of illegal drugs if the offense occurred during a period of enrollment for which you were receiving
federal student aid (grants, loans, and/or work-study). Do not count convictions that have been removed from
your record. Do not count convictions that occurred before you turned 18, unless you were tried as an adult.
1. Have you been convicted of the possession or sale of illegal drugs and the offense occurred
while you were receiving federal student aid (grants, loans, and/or work-study)?
☐ If your answer is Yes, continue to Question 2.
☐ If your answer is No, skip the remaining questions and complete the signature section.
☐ Yes
☐
No
2. Have all of your federal or state drug-related convictions been removed from your record?
☐ If your answer is Yes, skip the remaining questions and complete the signature section.
☐ If your answer is No, continue to Question 3.
☐ Yes
☐ No
3. Did the offense for possessing or selling illegal drugs occur during a period of enrollment for
which you were receiving federal student aid (grants, loans and/or work-study)?
☐ If your answer is Yes, continue to Question 4.
☐ If your answer is No, skip the remaining questions and complete the signature section.
☐ Yes
☐
No
4. Have you completed an acceptable drug rehab program since your last conviction?
An acceptable drug rehabilitation program must: a) include at least 2 unannounced drug tests; and b) be
qualified to receive funds from a federal, state, or local government or be qualified to receive funds from a
federal or state licensed insurance company; or be administered or recognized by a federal, state, or
local government agency or court, or be administered or recognized by a federal or state licensed
hospital, health clinic, or medical doctor.
☐ If your answer is Yes, skip the remaining questions and complete the signature section.
☐ If your answer is No, continue to Question 5.
☐ Yes
☐
No
5. How many convictions do you have for possessing drugs?
Count only federal or state convictions for the possession of illegal drugs if the offense occurred during a
period of enrollment for which you were receiving federal student aid (grants, loans, and/or work-study).
Do not count convictions that have been removed from your record. Do not count convictions that
occurred before you turned 18, unless you were tried as an adult. Indicate zero if no convictions.
____
______
6. What was the date of your last conviction for possessing drugs?
☐ If no convictions for possessing drugs, skip to Question 7.
☐ If you have only one conviction for possessing drugs, add one year to your last conviction date and
write this new date here: ___ /___ /___
☐ If you have two convictions for possessing drugs, add two years to your last conviction date and
write this new date here: ___ /___ /___
___ /
___ /___
7. The date lis
ted in Question 6 is (check the appropriate box):
☐ Before July 1, 2021: you are eligible for federal aid.
☐ Between July 1, 2021 and June 30, 2022: your eligibility needs to be reviewed by the Financial Aid Office to determine if
and when your federal aid eligibility will begin.
☐ After June 30, 2022: you are ineligible for federal aid for 2021-2022. Contact the Financial Aid Office if you complete an
ac
ceptable drug rehabilitation program.
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DRUG CONVICTION ELIGIBILITY WORKSHEET FOR 2021-2022 Complete this (State University of New York at Plattsburgh)

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Completed 1 February 2021

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