Fillable Form 5307497999: A O DeclineFinancialAidAwardsfor20192020 F (Woodland Community College)

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Form 5307497999: A O DeclineFinancialAidAwardsfor20192020 F (Woodland Community College)

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File type: PDF

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YubaCommunityCollegeDistrict
F
inancial
A
id
O
ffices
DeclineFinancialAidAwardsfor2019‐2020
_____________________________________________________ _______________________________
LastName  FirstStudentID
_____________________________________________________  _______________________________
MailingAddressPhoneNumber(Includeareacode)
_____________________________________________________
City State ZipCode
STUDENT:Completethissection.
1.Iamrequestingtodeclinefinancialaidforthefollowingsemester(s):
Fall2019Spring2020Summer2020
2.Iamdecliningthefollowinggrants/awards:
PellGrantFederalWork‐StudyFSEOGCALGrantEOPSCARE
Scholarship(s)
Other:_________________________________________________________
3.Iamrequestingtocancelmyfinancialaidaward(s)forthefollowingreason(s):
__________________________________________________________________________________________
__________________________________________________________________________________________

Note:Ifyouhavealreadyreceivedfinancialaidfundsforatermselectedabove,youmustrepayallfinancialaid
fundsbeforethisrequestcanbeprocessed.
Certification:Ihavereadandunderstandtheinformationstatedonthisform.Icertifythattheinformationprovidedonthisformis
trueandcorrecttothebestofmyknowledge.Iunderstandthatthisinformationwillbeusedtodeterminemyeligibilityandthatfalse
ormisleadinginformationmaybe
causefordenial,termination,and/orrepaymentoffinancialaidfunds.
_________________________________________________  _______________________________
StudentSignatureDate
FINANCIALAIDOFFICEUSEONLY
Awarded(s)Adjusted/Amended:PellFWSFSEOGCALGrantEOPSCARE
Scholarship(s)Other:__________________________________________________________________________
Term:Fall2019Spring2020Summer2020
Comments:_________________________________________________________________________________________
___________________________________________________________________________________________________
______________________________________________ ___
FinancialAidSignatureDate 

10/10/18
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
530‐749‐7999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
530‐661‐5725
LakeCounty Campus
15880DamRoadExtension
Clearlake,CA95422
707‐995‐7923
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Form 5307497999: A O DeclineFinancialAidAwardsfor20192020 F (Woodland Community College)

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Completed 25 July 2020

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