2019‐2020IndependentVerificationWorksheet
CustomGroup–V4
A.STUDENTINFORMATION
____________________________________________________________ ___________________________________________
LastNameFirstName M.I. SocialSecurityNumber
____________________________________________________________ ___________________________________________
MailingAddress(includeapt.no.)DateofBirth
____________________________________________________________ ___________________________________________
CityState ZipCode PhoneNumber(IncludeAreaCode)
B.HIGHSCHOOLCOMPLETIONSTATUS(Student)
Provideoneofthefollowingdocumentsthatindicateyourhighschoolcompletionstatuswhenthestudentwillbegincollegein
2019‐2020.AstudentwhoisunabletoobtainthedocumentationlistedbelowmustcontacttheFinancialAidOffice.
HighSchoolDiploma
Acopyofthestudent’shighschooldiploma.
Acopyofthestudent’sfinalofficialhighschooltranscriptthatshowsthedatewhenthediplomawasawarded.
AcopyofDDForm214
RecognizedEquivalentofaHighSchoolDiploma
Acopyofthestudent’sGeneralEducationalDevelopment(GED)certificate.
AnofficialGEDtranscriptthatindicatesthestudentpassedtheexam.
AstatecertificateortranscriptthattheStaterecognizesastheequivalentofahighschooldiploma(HiSET,TASC,orotherstate‐
authorizedexamination).
Acopy
ofthe“secondaryschoolleavingcertificate”orothersimilardocumentforstudentswhocompletedsecondaryeducationina
foreigncountry.
Anacademictranscriptthatindicatesthestudentsuccessfullycompletedatleastatwo‐yearprogramthatisacceptableforfullcredit
towardabachelor’sdegree.
Homeschool
Forahomeschooledstudentfromastatewherestatelawrequiresthestudenttoobtainasecondaryschoolcompletioncredentialfor
homeschool(otherthanahighschooldiplomaoritsrecognizedequivalent),acopyofthatcredential.
Forahomeschooledstudentfromastatewherestatelawdoesnotrequirethestudenttoobtainasecondaryschoolcompletion
credentialforhomeschool(otherthanahighschooldiplomaoritsrecognizedequivalent)atranscriptorequivalent,signedbythe
student’sparentorguardian,thatliststhesecondaryschoolcoursesthestudentcompletedandincludesastatementthatthestudent
successfullycompletedasecondaryschooleducationinahomeschoolsetting.
C.IDENTITYANDSTATEMENTOFEDUCATIONALPURPOSE(Student)
PleasereadandcompletetheIdentityandStatementofEducationalPurposeonpage2or3 ofthisform.Youmustcompleteone
oftwooptions. Witheitheroption,youmustprovideacopyof agovernment‐issuedphotoidentificationcardwiththeform.This
canincludebutisnotlimited
toadriver’slicense,otherstate‐issuedID,orpassport.
Option1:YoucansigntheforminthepresenceofaFinancialAidstaffmember.
Option2:Allowsthestudenttosigntheformbeforeanotarypublic.
D.CERTIFICATIONANDSIGNATURE(StudentandSpouse)
Eachpersonsigningthisworksheet,certifiesthatalltheinformation
providedistrueandcompletetothebestoftheirknowledge.
____________________________________________________________________________________________________________________
StudentSignature DateSpouse’sSignature(optional)
Date
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WARNING:Ifyoupurposelygivefalseormisleadinginformationon
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Office Use Only:
DATE received: