Office of Student Financial Aid
Unusual Enrollment History Verification Form 2020-2021
_______________________________________________________ XXX_______________________
Student Last Name Student First Name MI Banner ID Last 6 digits only
Address: _______________________________________________________________________________________
Telephone Number: ____________________________ Cell Phone Number: _____________________
Date: ______________________________ Email: ________________________________________
UNUSUAL ENROLLMENT HISTORY
The Department of Education has selected your 2020-2021 FAFSA application for review based on your unusual enrollment history
for the past four years as reported to the U.S. Department of Education. The U.S. Department of Education requires North Carolina
A&T State University’s Office of Student Financial Aid to review all students who are selected due to an unusual enrollment to
determine if there are valid reasons for the unusual enrollment history.
Please read and answer all questions below. Submit the required documents needed to complete the verification of your unusual
enrollment history. Mail the requested information to: North Carolina Agricultural and Technical State University, Office of
Financial Aid, 1601 East Market Street, Greensboro, NC 27411. You will be notified of the decision via your NCAT email.
All decisions are final and cannot be appealed to North Carolina Agricultural and Technical State University or the U.S.
Department of Education.
I.
VERIFICATION OF ENROLLMENT HISTORY
1. What college or university did you attend for the following academic years:
a) 2019-2020: ________________________________________
________________________________________
b) 2018-2019: ________________________________________
c) 2017-2018: ________________________________________
d) 2016-2017: ________________________________________
2. Submit a copy of your academic transcript for each institution you have attended. (The transcript maybe
an official or unofficial copy.)
3. Did you receive financial aid for the following academic years?
a) 2019-2020: Yes______________ No____________
b) 2018-2019: Ys______________ No____________
c) 2017-2018: Yes______________ No____________
d) 2016-2017: Yes_____________ No____________
UNENR 20/21
UPDATED: 11/19
4. Did you withdraw from one of the institutions listed above? If yes, please indicate which institution and
the date of the withdrawal:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
_________
Explanation for Unusual Enrollment History: If you need additional space, please attach another
Form. Explain why you have attended various institutions as indicated above.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
II.
CERTIFICATION AND SIGNATURE
By signing below I certify that all the information reported on this form is complete and correct.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be
sentenced to jail, or both.
__________________________________________________ XXX_______________________
Print Name Banner ID last 6 digits only
__________________________________________________ _______________________________
Student’s Signature Date
III. FINANCIAL AID COMMITTEE REVIEW
Financial Aid Committee: ______________________________Approved: ________ Denied: ________
Financial Aid Committee: ______________________________Approved: ________ Denied: ________
Financial Aid Committee: ______________________________Approved: ________ Denied: ________
Date: _______________________________________
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