Student Signature Date
For Office Use Only
FAC19NJA
New Jersey Alternative Financial Aid Affidavit
A. Student Information
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B. Requirements: You must initial to confirm each statement:
I have attended a New Jersey high school for at least three years __________________
I have or will receive a high school diploma for a New Jersey high school or have
attained its equivalent such as a New Jersey GED certificate __________________
Males only- I am registered with selective service and have attached a copy of
my registration __________________
I am NOT a non-immigrant alien holding a currently valid visa. (Federal law
defines a non-immigrant as a person admitted temporarily to the United States with
any of the following visas: A, B, C, D, E, F, G, H, I, J, K, L, N, O, P, Q, R, S, T,
TN, TD, V, TROV, NATO, or other non-immigrant visas) __________________
I understand I must meet all other financial aid requirements including but not
limited to being enrolled in a degree or certificate program, meeting Satisfactory
Academic Progress guidelines, and reapplying annually __________________
C. Affidavit
By signing this document below, I hereby state that if I am a non-citizen without lawful immigration status,
I have filed an application to legalize my immigration status or will file an application as soon as I am
eligible to do so.
D. Declaration of True and Accurate Information
I, the undersigned, declare that the information I have provided on this form is true and accurate. I
understand that this information will be used to determine my eligibility for state financial aid assistance. I
further understand that if any of the above information is found to be false, I will be liable for repayment of
all assistance received and may be subject to disciplinary action by the University.
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Last%Name%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%First%Name%%%%%%%%%%%%%%%%%%%%%M.I.%%%%%%%%%%%%%%%%%%%%%%%%%MCC%ID%#%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%Cell%Phone%#!
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