2020-2021 IDENTITY & STATEMENT OF
EDUCATIONAL PURPOSENOTARIZED
STUDENT NAME BRANDMAN ID NUMBER
Identity and Statement of Educational Purpose
(To Be Signed With Notary)
If the student is unable to appear in person at Brandman University to verify his or her identity, the student
must provide:
(a) A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary
statement below, such as, but not limited to, a driver’s license, other state-issued ID, or passport; and
(b) The original
notarized Statement of Educational Purpose provided below.
Statement of Educational Purpose
I certify that I _____________________________ am the individual signing this Statement of
(
Print Student’s Name)
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 Brandman University for 2020-2021.
_________________________________________ _______________
(Student’s Signature) (Date)
______________________
(Student’s ID Number)
Notary’s Certificate of Acknowledgement
State of ________________________________________________________________________
City/County of ___________________________________________________________________
On_____________________, before me, ____________________________________________,
(Date) (Notary’s name)
personally appeared, ____________________________________________, and provided to me
(Printed name of signer)
on basis of satisfactory evidence of identification _______________________________________
(Type of government-issued photo ID provided)
to be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
(seal) ________________________________________
(Notary signature)
My commission expires on _____________________
(Date)
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