Financial Aid Office, IWU National & Global 1900 West 50
th
Street Marion, IN 46953-9393 indwes.edu
800.621.8667 option 4 765.677.2516 765.677.2030 Fax IWUfinaid@indwes.edu
FINANCIAL AID OFFICE
Complete this form if you will receive funding from any of the additional aid sources represented below. Federal regulations
require students to notify the financial aid office of funding they will receive from certain aid sources and that we consider
those funds when calculating student financial aid eligibility.
DO NOT report standard veterans benefits (e.g., Chapter 30 Montgomery, Chapter 31 Vocational Rehabilitation,
Chapter 33 Post 9/11), federal Title IV grants indicated on the Student Aid Report (SAR), standard state-funded
grants/scholarships, or funding from a 529 College Savings Plan.
Student Information
________________________________________ ____ _______________________________________________
First Name M.I. Last Name
__________________ OR __________________ ______________________________________
Student ID Last 4 Digits of SSN Phone Number
CHECK THE BOX FOR AND COMPLETE EACH SECTION THAT APPLIES
Employer Reimbursement
Employer Name:__________________________________________________________________________________
I have included a copy of my employer’s reimbursement policy
Please complete the following if no policy is included
My employer calculates the amount of tuition funded in the following way:
As a per credit hour rate of $_______________ with: An annual maximum of $_______________
No annual maximum
As a percentage, _______%, of IWU’s tution rate with: An annual maximum of $_______________
No annual maximum
My employer’s policy includes payment for books: No Yes, with no limit Yes, up to $_____________
My employer’s policy includes payment for fees: No Yes, with no limit Yes, up to $_____________
Grants and Scholarships from Outside Sources
Funding Source/Grant or Scholarship Name:___________________________________________________________
Please include a copy of the payment guidelines for this funding source
State-Administered Vocational Rehabilitation Services and Workforce Development
Funding Source:__________________________________________________________________________________
I have included a copy of the payment guidelines for this funding source
Please complete the following if no payment guideline document is included
Total amount awarded by this funding source: $________________
This funding source may be applied to books charges: No Yes, with no limit Yes, up to $_____________
This funding source may be applied to fees: No Yes, with no limit Yes, up to $_____________
Student Signature (required for faxed, mailed, or hand-delivered forms)
____________________________________________________________________________ ______/______/______
Student Signature Date
Email, fax, mail, or deliver the completed form to the Financial Aid Office using the contact information listed below
EMAILED FORMS MUST BE SENT FROM THE IWU STUDENT EMAIL ACCOUNT
OR
