Fillable Hathaway Extension Request (Eastern Wyoming College)

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Hathaway Extension Request (Eastern Wyoming College)

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11/2018
Provisional Opportunity Scholarship Extension:
According to W.S. 21-16-1305(a)(ii), students receiving the Provisional Opportunity level of the Hathaway Scholarship shall
receive a maximum of the equivalent of four (4) full-time semesters, or forty-eight (48) credit hours. Should students receive a
technical certificate (e.g., an Auto-Body Certificate) at one of the seven Wyoming community colleges during those four (4)
full-time semesters, the scholarship may be extended at the community college for an additional forty-eight (48) credit hours
to pursue an additional certificate or Associate's Degree. Should students receive an Associate's Degree during the four (4)
initial full-time semesters, students may extend the scholarship at the University of Wyoming for an additional forty-eight (48)
credit hours to pursue a Bachelor's Degree.
Professional Degree Extension:
Ordinarily, the Hathaway Opportunity, Performance, and Honor scholarships are available to community college students for a
maximum of four full-time semesters. W.S.21-16-1304(b), subsection (g), however, provides for an extension of eligibility if
the student “has earned a certificate or degree from a Wyoming community college or has otherwise successfully completed
sufficient courses for eligibility to enroll in courses within a program offered by a Wyoming community college which leads
to a professional degree.” W.S. 21-16-1304(b). The final sentence of this provision states that the scholarship “shall not
support enrollment in coursework at an institution other than a Wyoming community college or the University of Wyoming.”
In order to qualify for this, both of the following components must be met: 1. The student must have completed the requisite
academic program, that is, either received a certificate or degree, or be eligible to enroll in the requisite program; and 2. There
must be a program that leads to a professional degree, and the program must be offered by a Wyoming community college.
The WDE, in conjunction with the Wyoming Attorney General's office, defines a professional degree as one that is generally
both necessary and sufficient to enter a particular profession. For example, an M.D., J.D., or ADN are all considered
professional degrees. In order for the extension to be completed at a Wyoming community college, the community college
must offer a professional degree program that the University of Wyoming does not offer. Examples of such programs may
include: Radiography or Dental Hygiene. If the University of Wyoming offers the program, the student would not be eligible
to complete the extension at the community college
Eastern Wyoming College views our Veterinary Technology (A.A.S.) program as a Professional Degree program. Students
seeking a degree in this program would be eligible for a professional degree extension if they have met the criteria to maintain
their Hathaway eligibility.
Have a situation that does not meet the defined types of extensions?
If you are requesting an extension that does not meet the criteria for Provisional Opportunity or Professional Degree
Extensions, please contact our office. We cannot
guarantee that other types of extension requests will be approved; however,
we would like to discuss your specific situation to determine eligibility.
___________________________________________________________ ____________________ __________________________
Last Name First Name M.I. EWC Student ID Number Social Security Number (last four digits)
___________________________________________________________ _______________________________________________
Mailing Address (include apartment number) E-mail Address
___________________________________________________________ _______________________________________________
City, ST, Zip Phone Number (include area code)
STUDENT INFORMATION
RETURN COMPLETED FORM TO:
EWC Financial Aid Office
3200 West C Street
Torrington, WY 82240
p: 307.532.8327 f: 307.532.8222
financialaid@ewc.wy.edu
Hathaway Scholarship
Scholarship Extension Request
TYPES OF HATHAWAY EXTENSIONS
• I am requesting to begin a Hathaway Extension for the following semester:
Fa
ll 20___ Spring 20___ Summer 20___
• Which type of Extension are you requesting? (Check one)
___ Provisional Opportunity Level Extension
___ Professional Degree Extension (this is typically reserved for our Veterinary Technology students)
___ Other
• What is your major/degree? Anticipated graduation date(s)?
Please list all programs for which you are currently taking coursework, or for which you will
be taking coursework.
Please include the semester/year of graduation for each program listed.
• I plan on enrolling/registering as: (Check one)
Hathaway is prorated for less than full-time enrollment, and can only pay for non-remedial credits.
___ Full-time (12+ credits)
___ Part-time (6-11 credits)
___ Less than Part-time (1-5 credits – you can only utilize this option for summer terms)
• Please state the reason for your extension request. Additional pages may be added if necessary.
EXTENSION REQUEST INFORMATION
EXTENSION REQUEST STATEMENT
11/2018
• Please answer each of the following by checking Yes or No:
___ Yes ___ No Are you a U.S. Citizen?
___ Yes ___ No ___ N/A If male, have you completed Selective Service Registration? If female, check N/A.
___ Yes ___ No Are you in default on a federal Title IV education loan?
___ Yes ___ No Are you in overpayment (owe a refund) on a federal Title IV grant?
___ Yes ___ No Have you been convicted of a felony in Wyoming or another jurisdiction?
___ Yes ___ No Are you incarcerated?
• Please answer each of the following by checking Yes or No:
___ Yes ___ No I understand that this request cannot be granted unless permissible by the statute.
___ Yes ___ No I understand that I should make educational/financial plans based on the original eligibility
determination by the institution.
___ Yes ___ No I understand that all eligibility requirements must be met to maintain eligibility for the Scholarship.
___ Yes ___ No I understand that by electing to use additional semesters at a community college, I am reducing future
semesters of eligibility at the University of Wyoming.
___ Yes ___ No I understand that Hathaway Scholarships can be received for a maximum of the equivalent of
eight full-time semesters (96 TOTAL credits).
Student signature: _______________________________________________ Date: ____________________________
• Are you approving this student’s Extension Request? ___ Approved ___ Denied
• Please state the reason for approval/denial. If approved, please include the terms of the approval (credits, program, etc.)
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
Kelcie McBride
EWC Hathaway Coordinator Signature: _________________________________________ Date: _________________
EWC Financial Aid Staff Signature: _____________________________________________ Date: _________________
STUDENT SIGNATURE
ADDITIONAL ELIGIBILITY CRITERIA
EWC FINANCIAL AID – OFFICE USE ONLY
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Hathaway Extension Request (Eastern Wyoming College)

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Completed 22 July 2020

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