ATB20
ABILITY TO BENEFIT FORM
(2019-2020 Academic Year – V4,V5)
2800 S Lone Tree Rd Flagstaff, AZ 86005-2701 PH: 928-226-4219 FAX: 928-226-4110 finaid@coconino.edu
FA-702-ATB20 20181003
On the Free Application for Federal Student Aid (FAFSA) you were asked if you have a High School Diploma,
a GED, or have completed Home-Schooling. Provide one of the following documents that indicate the
student’s high school completion status when the student will begin college in 2019–2020:
Please check ONE of the following:
I have received my High School Diploma and
have attached a copy of it or a copy of my High
School transcript showing graduation date.
High School Name: _________________________
Location (City / State): _______________________
Date earned (Month /Year): ___________________
I have received my GED or State-authorized
examination such as the High School
Equivalency Test (HiSET) or the Test
Assessing Secondary Completion (TASC). I
have attached this documentation.
Location (City / State):_______________________
Date earned (Month /Year):___________________
I have completed a secondary home schooling
program which is recognized by my state and
have attached documentation from the State.
State of Approval:___________________________
Date completed (Month / Year):________________
I have completed at least a two-year
Associate’s degree program that is acceptable
for full credit toward a bachelor’s degree. An
official academic transcript from my previous
college has been submitted to Registration and
Enrollment Services at CCC.
School Name: _____________________________
Location (City / State): _______________________
Date earned (Month /Year): ___________________
I do not have any of the approved credentials. I understand that I am not eligible for financial aid
I certify that the information provided on this form is complete and accurate to the best of my knowledge. I understand that submission
of false information may result in a delay or denial of federal financial aid and may subject me to criminal charges. I understand that
purposely giving false or misleading information may result in a fine of up to $20,000, being sent to prison, or both.
Student Signature Date
CCC ID# Last Name First Name MI
Mailing Address City State Zip Code
Telephone No. (include area code) Email Address
