Federal Direct Loan Program
Student Loan Request Form
Fall 2019-Spring 2020
It is important that you read the Las Positas College Direct Loan Brochure and the Federal Direct Loan Counseling guides
Applicant Name:
SSN #
Date of Birth
E-mail address
Street Address:
City
_Zip Code
Home /Cell phone #:
Drivers License # and State:_
Annual Loan Limits for Direct Subsidized and Unsubsidized Loans
Dependent
Independent
If your academic level at Las Positas is…
You May Qualify for
You May Qualify for
1
st
Year: 0 29.5 units earned at LPC
$5,500 (Maximum $3,500 subsidized)
$9,500 (Maximum $3,500 subsidized)
2
nd
Year: 30 or more units earned at LPC
$6,500 (Maximum $4,500 subsidized)
$10,500 (Maximum $4,500 subsidized)
The Financial Aid office will use the grade level determined by the Las Positas A&R office. If you intend to include units earned from a prior school to establish 2nd
year loan eligibility, you must request official academic transcripts be evaluated by Las Positas A&R and documented for the Financial Aid Office.
I anticipate graduating/completing my program of study at Las Positas College:
December_
May
August_ (Write the YEAR next to the appropriate month indicated)
I am requesting a loan for the amount indicated below or the lesser amount for which I am eligible.
$: Borrowing Limits The actual loan amount is determined by individual eligibility, not
to exceed the maximum loan limits indicated above. We recommend that you request
a reduced loan amount if the maximum limit is not needed.
If I am not eligible for the requested loan amount through a subsidized Direct Loan, I would like to borrow the remaining
requested funds through an Unsubsidized Direct Loan. I understand that I am responsible for payment of all interest
calculated on my unsubsidized student loan, as interest is not paid by the federal government.
No, I do not want an UNSUBSIDIZED Loan Yes, consider me for an UNSUBSIDIZED Loan
I understand that, in order to obtain a loan, I must complete Entrance Loan Counseling and sign a Master Promissory
Note (MPN) by logging onto the website www.studentloans.gov. I understand that before I can receive my second
payment I must first complete Exit Loan Counseling at www.nslds.ed.gov/nslds
Applicant 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.
BEFORE submitting this form so that you understand policies and procedures involved in the student loan process.
Student College ID W#
Student Education Plan ____
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.