2020-2021 IDENTITY & STATEMENT OF EDUCATIONAL PURPOSE
Student Name: ________________________________ ID Number: ____________________________ Telephone Number: __________________
Mailing Address: __________________________________________________________ Email Address: ___________________________________
A. IN PERSON
The student must appear in person at College Financial Aid Office to verify his or her identity by presenting a valid government-issued photo
identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the
student’s photo ID that is annotated with the date it was received and the name of the official at the institution authorized to collect the
student’s ID. In addition, the student must sign, in the presence of the institutional official, the following:
PROOF OF HIGH SCHOOL COMPLETION: (Staff use only - Check which applies)
❏ Proof of high school equivalency
❏ Copy of final official high school transcript that shows the date when the diploma was awarded
❏ Copy of GED
Copy of document received. Date received: _____________ Accepted by: ______________
Statement of Educational Purpose
I certify that I (Print Student’s Name) _____________________________ am the individual signing this Statement of Educational Purpose and that
the Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending the college for the
current aid year.
_________________________________________ _______________________
(Student’s Signature) (Date)
_________________________________________ _______________________
(Staff Witness Initials) (Date)
B. BY MAIL (Originals required, fax not acceptable)
If the student is unable to appear in person at College Financial Aid Office to verify his or her identity, the student must provide both: (To Be
Signed with Notary)
(a) A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary statement below, such as but not limited to
a driver’s license, other state-issued ID, or passport; and
(b) The original notarized Statement of Educational Purpose provided below.
Notary’s Certificate of Acknowledgement
State of ________________________________________________________________________
City/County of __________________________________________________________________
On (Date)___________________, before me (Notary’s name), ___________________________
Personally appeared (Printed name of signer), _________________________________________,
and provided to me on basis of satisfactory evidence of identification (Type of government-issued photo ID provided)
_______________________________________ to be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
(Seal) ________________________________________
(Notary signature)
My commission expires on (Date) _________________________
Monroe, LA 71203
financialaid@ladelta.edu
318-345-9005 Phone
318-345-9006 FAX
www.ladelta.edu
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