RETURN THIS COMPLETED FORM TO:
Wayne Community College - Financial Aid Office - PO Box 8002 - Goldsboro, NC 27533-8002
FAX: 919-736-9425
Wayne Community College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate degrees. Contact the
Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Wayne Community College.
The Commission on Colleges may be contacted only if there is evidence that Wayne Community College is significantly non-compliant with a requirement or standard.
Accreditation standards are located at: http://www.sacscoc.org/principles.asp. Inquiries about Wayne Community College, such as admission requirements, financial aid,
educational programs, etc. should be addressed directly to Wayne Community College and not the Commission’s office.
1. Use the space below to provide a detailed, signed, and dated personal statement describing your
circumstance(s). This information must include the last date you were in contact with your parents, the nature of
contact, the location of your parents, and how you are presently supporting yourself. Attach additional paper if
needed.
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2. Provide two (2) typed, signed, and dated statements from third-party professionals who can confirm your extenuating
c
ircumstances. Examples of third-party professionals include teacher, counselor, doctor, clergy, law enforcement
official, government agency or court on official letterhead. These statements must include their relationship with
you, any knowledge they have of your relationship with your parents, and your ability to support yourself.
*These letters must include the name, title, address, and telephone number of the person(s) providing the
statement. Note: if the letters are not from a professional third party, they MUST be notarized.
3. Attach relevant supporting documentation including, but not limited to, court documents, police reports, and/or officia
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doc
uments from the Department of Social Services.
CERTIFICATION AND SIGNATURE
By signing below, I certify that the information provided on this form and all attached documentation is true and accurate to the best of
my knowledge. I understand that completion of this form is not a substitute for payment of applicable charges to the College.
Purposefully giving false or misleading information may result in fines up to $20,000, imprisonment or both. The U.S.
Secretary of Education has the authority to verify information reported on this application with the IRS and other federal
agencies.
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Student Signature Date
NOTE: An approved override does not automatically make a student eligible for more financial aid
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