Quincy College Phone: 617-984-1620
Financial Aid Office financialaid@quincycollege.edu
FINANCIAL AID INFORMATION FORM 2020-2021
Please select one only: Quincy Campus Plymouth Campus Online
GENERAL INFORMATION
Full Name: ___________________________________________ Date of Birth: ___________________
Social Security #: ____________________________ Student ID #: _____________________________
Other Name(s) under which records my appear: ____________________________________________
Mobile Phone: ______________________________ Home Phone: _____________________________
Home Address: ______________________________________________________________________
City: __________________________________ State: _________________ Zip Code: _____________
Mailing Address (if different than Home Address): _______________________________________________
Email Address: ______________________________________________________________________
Have you ever received financial aid through Quincy College? Yes No Semester: __________
Do you wish to be considered for Federal Work-Study employment? Yes No
Have you ever received a high school diploma or GED/HiSET? Yes No Grad Year: __________
Have you already earned a Bachelor’s Degree? Yes No Institution: _____________________
COLLEGE TRANSFER INFORMATION
If you are attending another college or post-secondary school during the 2020-2021 academic year,
please provide the name of the school:
School Name: ________________________________________ Dates attended: __________________
AUTHORIZATION TO CREDIT CHARGES
If you have sufficient aid to cover charges in excess of tuition and fees, you may authorize Quincy College to cover these charges.
Credit at the bookstore for books.
Non-waived insurance: All students taking at least 9 credits must be covered by medical insurance. If you are not already
covered, you must purchase insurance through Quincy College.
By signing, this application, you acknowledge that you are responsible for paying any charges not covered by final
awarded funds.
Please complete both sides of this form.
RELEASE OF INFORMATION
The Office of Financial Aid will release financial aid information to the following individuals, agencies and organizations. The student
must notify the office in writing if they do not wish for information to be released.
Applicant (and parents of dependent students)
Organizations sponsoring financial aid programs for which you may be eligible.
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CERTIFICATION STATEMENT ON REFUNDS & DEFAULT
I certify that I do not owe a refund on any grant or loan, am not in default on any loan or have made satisfactory arrangements to
repay any defaulted loan, and have not borrowed in excess of the loan limits, under Title IV programs, at any institutions.
NOTIFICATION OF RETURN OF TITLE IV FUNDS
The Department of Education requires this calculation to be done for any financial aid recipient who does not successfully complete any
courses during a given semester. This applies to both official and unofficial withdrawals, failures, and incomplete grades. Any outstanding
balance that results from the retraction or adjustment of financial aid is the responsibility of the student.
NOTIFICATION OF AUTOMATIC DIRECT LOAN
Quincy College is authorized to make multiple loans under the same Master Promissory Note (MPN) for more than one academic year. If you
signed one MPN for all of your Direct Subsidized Loans and Direct Unsubsidized Loans, you must notify the College in writing if you do not
wish to borrow loans for a specific year. Loans will automatically disburse if you are enrolled in 6 or more credits and have assigned an MPN
to Quincy College within the last 10 years.
DISCLAIMER
The Financial Aid Office reserves the right to amend or cancel any award within Federal, State, and College guidelines. Quincy College is not
responsible for notifying students of exceeding the maximum aggregate Federal Direct Stafford Loan limits or Pell Life Eligibility percentage
used. Students can view revised awards on their QC portal at www.quincycollege.edu. It is the student’s responsibility to consistently review
awards and account activity each semester to be aware of any changes. Any resulting balance is the student’s responsibility.
STATEMENT OF EDUCATIONAL PURPOSE
I will use the Title IV money only for expenses related to my study at Quincy College.
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Warning: To receive any Title IV financial aid, you must validate the certification statement on refunds
and
default, and the stalemate of education purpose with your signature. You must be registered with
the Selective
Service if you are required to register. If you purposely give false or misleading
information, you may be subject
to up to a $1 0,000
fine, imprisonment for up to 5 years, or both.
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SIGNATURE(S)
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I certify that all the information I have entered on this form is correct and complete. I understand that I am responsible for all
charges
not covered by my financial aid.
Student Signature
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Date ________________________
Parent Signature
Date ___________________________
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(Parent signature is required for Dependent students only)
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IMPORTANT: The Free Application for Federal Student Aid (FAFSA) must be completed in addition to
this form in order to
determine financial eligibility.
In accordance with federal civil rights law, Quincy College does not discriminate in its educational programs and activities on the basis of race, color, national
origin, ancestry, sex, gender, gender identity, gender expression, sexual orientation, physical and/or mental disability, age, religion, medical condition, veteran
status, marital status, genetic information, or any other characteristic protected by institutional policy or state, local, or federal law. The requirement of non-
discrimination in educational programs and activities extends to employment and admission. The following persons have been designated to handle inquiries
regarding the non-discrimination policies, including Title IX and Section 504, relative to student matters is Susan Bossa, AVP for Student
Development, sbossa@quincycollege.edu and Title IX, Section 504, and Title VI relative to employee related matters is Christopher Bell, Assistant to the
President, cbell@quincycollege.edu.