New Mexico Lottery Consortium Agreement
Financial Aid * 417 Schepps Boulevard * Clovis, NM 88101
Phone: (575) 769-4158 * Fax: (575) 769-4027
What is a Consortium Agreement?
A consortium agreement allows a student to receive financial aid funding at one institution for the combined
enrollment hours at two institutions.
*Deadline for consortium is always the last day to charge at CCC Bookstore.*
Student Section
SID#: SSN: Phone Number
Name:
Last First Middle Initial
Address:_
Street or Box Number City State Zip Code
Student must be enrolled in at least six credit hours at Clovis Community College for Fall and Spring.
You may not take more hours at the host institution than at CCC. You must turn in a copy of you class
schedule and billing statement from the host institution.
Enrollment period (select one): Fall
Spring
Year Year
Number of hours at Clovis Community College:
Number of hours at Host Institution Name of Host Institution
Are you receiving N.M. Lottery Success Scholarship from the home institution? yes no
Note: The student is responsible for obtaining all signatures before submitting this form to the office
of Financial Aid at Clovis Community College.
Host Institution Section
Host institution must confirm information listed above.
Hours:
Tuition Only: $
Host institution Financial Aid signature:
Name Phone Date
Student Signature:
click to sign
signature
click to edit
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click to sign
signature
click to edit
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