VWI4O
2020-2021 Verification Worksheet Form 4
Student ID Number
Student Name:
Phone Number:
Form must be completed in blue or black ink. Failure to accurately complete this form may result in a
delay of processing or change of financial aid eligibility. Additional documentation may be requested.
Read instructions carefully before completing.
Section 1: High School Completion Status
Please submit documentation to verify you have completed a high school education. Acceptable
documentation can include:
A high school diploma or a copy of an official high school transcript. Transcripts must verify graduation
completion date
GED certificate or transcript
Visit www.diplomasender.com
if you need a copy of a GED obtained in the State of Colorado.
A transcript that indicates that you have successfully completed at least a two-year program that is acceptable
for full credit towards bachelors degree at any participating school
Home school credential or transcript
If high school completed in foreign country, a copy of the “secondary school leaving certificateor similar
document.
If a foreign High School transcript is provided it must be translated and evaluated. For a list of qualified service
providers, please visit www.naces.org/members.
Type of documentation submitted:
Designated institutional official:
(School official's printed name)
Section 2: Identity
MUST BE COMPLETED & SIGNED AT THE FINANCIAL AID OFFICE
If unable to appear in person at the Financial Aid Office, you must complete this section with a notary
You must appear in person at Financial Aid Office to verify your
(Name of insti tution)
identity by presenting a valid unexpired government-issued photo identification (ID), such as, but not limited
to, a drivers license, other state-issued ID, or passport. The institution will maintain a copy of your photo ID.
Type of documentation submitted:
Designated institutional official:
(School official's printed name)
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VWI4O
Student ID Number: S
Section 3: Statement of Educational Purpose
MUST BE COMPLETED & SIGNED AT THE FINANCIAL AID OFFICE
If unable to appear in person at the Financial Aid Office, you must complete this section with a notary
In addition, you must sign, in the presence of the institutional official, the following:
I certify that I am the individual signingthis
(Student’s printed name)
Statement of Educational Purpose and that the federal student financial assistance
I may receive will only be used for educational purposes and to pay the cost of attending
for 2020-2021.
(Name of insti tution)
Student Signature: Date:
Notary Section Instructions: Please Read
This section should only be completed if you are unable to appear in person at the institution with a designated official.
This form (the original on which the seal is visible) should be mailed to the Financial Aid Office at your institution along
with the copy of the government-issued identification and high school documentation.
Notary’s Certificate of Acknowledgement
State of Ci ty/County of
On
, before me
(Date) (Notarys name)
Pers onal ly appeared
and proved to me on the basis of
(Printed name of
si gner)
Satisfactory
evidenceof Identification to be theabove-na med
(Type of unexpired government-issued ID provided)
My commissi on expires on , 20
(Seal)
Notary (Print):
Notary (Signature):
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