OFFICE OF FINANCIAL AID
AND SCHOLARSHIPS
Check your myClackamas account for all financial aid correspondence and your Award Letter.
Secure submission of documents can be completed in person, by mail, or fax to:
Office of Financial Aid and Scholarships · Roger Rook Hall · 19600 Molalla Avenue, Oregon City, OR 97045
Phone: 503-594-6082 · Fax: 503-722-5864 · e-mail: finaid@clackamas.edu · www.clackamas.edu
02/29/19 tms
2019-2020 Unusual Enrollment History Verification
(Summer Term 2019 Spring Term 2020)
Student Last Name
Student First Name
Student ID#
Date of Birth
I have already completed this process for CCC: Yes No
If you answered Yes, skip to the signature line. If you answered No, continue to Step 1.
To be completed by students who have an Unusual Enrollment History as determined by the Department of Education.
Please allow up to two weeks for review.
STEP 1. Attach your unofficial transcript or grade report from each of the schools you attended during the past four
award years (Award Years 2015-2016, 2016-2017, 2017-2018 and 2018-2019).
While official transcripts are not required for this process, students are strongly encouraged to submit an
official transcript from each regionally accredited institution they’ve attended in order to receive credit for
previous coursework.
STEP 2. Mark the appropriate box:
I received academic credits from all the institutions that I attended during the past four award years (Award
Years 2015-2016, 2016-2017, 2017-2018 and 2018-2019) as confirmed by my transcripts or grade reports.
I did not receive any academic credits from at least one of the institutions that I attended during the past four
award years (Award Years 2015-2016, 2016-2017, 2017-2018 and 2018-2019). Please submit a typed and
signed statement for each school attended (include CCC, if applicable) explaining why you did not earn any
credits. Supporting documentation must be provided.
Incomplete submissions will be denied
_________________________________________________ _________________________________
Student Signature Date
***************************************FINANCIAL AID OFFICE USE ONLY*************************************
APPROVED DENIED
COMMENTS __________________________________________________________________
___________________________________________________________________________
FA Signature _________________________________________ Date: _________________________________
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome