PURDUE
UNIVERSITY
®
NORTHWEST
Identity and Statement of Educational Purpose Form 2020-2021
(To be Signed at Purdue University Northwest)
**PLEASE DO NOT MAIL THIS FORM**STUDENT MUST APPEAR IN PERSON**
STUDENT NAME: _____________________________________ DATE: ______________
The Office of Financial Aid at Purdue University Northwest will request this documentation only if it is needed to complete
your financial aid file.
Verification is a process required by the U. S. Department of Education to review the accuracy of information reported on
the Free Application for Federal Student Aid (FAFSA). Further processing of your financial aid will not occur until the
information requested below has been received by the Office of Financial Aid.
DIRECTIONS: The student must appear in person at Purdue University Northwest to verify his or her identity by
presenting a valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-
issued ID, or passport. Purdue University Northwest will maintain a copy of the student’s photo ID that is annotated with
the date it was received and the name of the official at Purdue University Northwest authorized to collect the student’s ID.
In addition, the student must sign, in the presence of the Purdue University Northwest official, the following:
Statement of Educational Purpose
I certify that I ___________________________________ am the individual signing this Statement of
(Print Student’s Name)
Educational Purpose and that the federal student financial assistance I may receive will only be used for educational
purposes and to pay the cost of attending Purdue University Northwest for 2020-2021.
CERTIFICATION: (Provide required signature and PUID)
Sign and date this form certifying that the information provided is complete and correct.
Student Signature: ______________________________________ Date: _________________
PUID: ______________________________________________
**PLEASE DO NOT MAIL THIS FORM**STUDENT MUST APPEAR IN PERSON**
Office Use Only – RRAAREQ: ______VSVP21 (R)
2200 169
th
Street Hammond, IN 46323
(219) 989-2301 fax (219) 989-2141
1401 S. U.S. Hwy. 421 Westville, IN 46391
(219) 785-5460 fax (219) 785-5653
