Supplemental Loan Information
You are required to estimate, as best you can, the value of any support from outside resources that you receive,
whether cash or otherwise, while you are in college. ('Educational Expenses' refer to registration fees, books,
transportation, living expenses such as rent and food, clothing and personal expenses.)
Please check all statements that apply and complete information requested: ('Annual' refers to Current School Year)
[ ] I am receiving educational support through the Cal Works program at Las Positas.
[ ] I am receiving a book voucher from EOPS or another program at Las Positas
[ ] I am receiving financial help from another program at LPC. Name of program:
[ ] I receive Section 8 subsidized housing Monthly value $
[ ] I am a recipient of a Tri Valley Housing Scholarship Monthly value $
[ ] I receive another type of subsidized housing or am residing in a shelter or protective
living arrangement for which I do not pay rent. Monthly value $
[ ] I am receiving educational support through the Ca. State Dept. of Rehabilitation, Monthly amount $
or the Veterans Department of Rehabilitation (Chapter 31).
[ ] My parents or another family member is helping me meet my school expenses, or Annual amount $
are taking care of or subsidizing my living expenses.
Please explain:
[ ] A non-relative or my significant other is helping me meet my school expenses, or is Annual amount $
taking care of or subsidizing my living expenses.
Please explain:
[ ] I am receiving free rent from my parents or someone else, which is helping me to get by on a tight budget.
(DO NOT CHECK if you have checked one of the above two statements)
[ ] I have received scholarships this school year that were not processed through the college
Name of Scholarship
Amount
Name of Scholarship Amount
Name of Scholarship Amount
[ ] My work is paying for or reimbursing me for [ ] enrollment fees [ ] books and supplies
I certify that all information provided on this form is true and complete to the best of my knowledge.
Student Signature:
Date:
By signing this application I certify that I will use my federal student aid only to pay the education-related
costs of attending an institution of higher education, in accordance with federal law.