Fillable PHEAA COLLEGE ENROLLMENT CHANGE STUDENT AUTHORIZATION STATEMENT Shippensburg (Shippensburg University of Pennsylvania)

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PHEAA COLLEGE ENROLLMENT CHANGE STUDENT AUTHORIZATION STATEMENT Shippensburg (Shippensburg University of Pennsylvania)

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The PHEAA COLLEGE ENROLLMENT CHANGE STUDENT AUTHORIZATION STATEMENT Shippensburg (Shippensburg University of Pennsylvania) form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for Shippensburg University of Pennsylvania

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PHEAA COLLEGE ENROLLMENT CHANGE
STUDENT AUTHORIZATION STATEMENT
Student’s Name
______________________________________
Student’s Home Address
____________________________________
____________________________________
Award Year: 2020-2021
Fall & Spring Semester
Fall Semester Only
Spring Semester Only
Housing Status: (Check one)
Dormitory
Off-Campus (Living away from home and not in dormitory housing)
C
ommuter (Living at home with parents)
By signing this statement, I authorize the institution referenced above to request and receive any and all
information contained in my 2020-21 PHEAA State Grant Record on file with the Pennsylvania Higher
Education Assistance Agency (PHEAA). I understand that all information submitted to PHEAA may be
released to the institution listed above for the purpose of evaluating my eligibility for financial assistance.
I further authorize PHEAA to forward to the herein-named postsecondary institution all information on the
Application and all information subsequently submitted to or acquired by the Agency.
____________________ _______________________________________
Date Student’s Signature
This document should be maintained in the student’s file at the institution. If the institution has on file a signed copy of the Free
Application for Federal Student Aid (FAFSA), a signed Student Aid Report (SAR), or the student’s actual enrollment at this institution
has been certified, this form does not need to be completed.
Social Security Number
xxx-xx- ________
Name of School:
Shippensburg University
OE College Code:
00332600
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PHEAA COLLEGE ENROLLMENT CHANGE STUDENT AUTHORIZATION STATEMENT Shippensburg (Shippensburg University of Pennsylvania)

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Completed 1 February 2021

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