FOUNDATION
F O U N D A T I O N
Name:
Address:
E-mail:
Craon Hills College Foundaon
Student Informaon
Referral Informaon
Foundaon Use Only
Statement of Purpose
Yes No
I understand that failure to repay these funds may aect my ability to remain in or enroll in
classes at Craon Hills College.
Do you currently have an unpaid book loan with the CHC Foundaon?
Will student receive Financial Aid? When will student repay loan?
Is student working? Will student make payments?
Brief statement of need and purpose of loan:
(Book Loans not to exceed $350.00 for Fall & Spring Semesters; $200 for Summer Session.)
Referred by:
Title:
Student ID #:
Telephone:
Emergency Textbook Loan Agreement
Signature:
Extension:
(CHC Counselor or Designee)
(Printed Name)
Approval - Foundaon Representave:
Date:
Signature:
All Students applying for a book loan must be referred by the CHC Counseling Oce.