REV 043020
320 Corporate Dr, Portsmouth NH 03801
gbfinaid@ccsnh.edu Ph: (603) 427-7600 ext. 7501 Fax:
(603) 334-6308
REQUEST FOR BOOK ADVANCE
STUDENT NAME: STUDENT ID:
SEMESTER AND YEAR: AMOUNT:
I understand this is a debt that must be repaid, and that
1. I am requesting an advance on the anticipated credit balance to be created by my federal financial aid funds.
2. To qualify, I must have a complete financial aid application. The financial aid I have accepted must be greater than the
amount of my tuition and fees, and must be scheduled to create a credit balance which will cover the book advance I
request.
3. To qualify, if I have accepted a Direct Student Loan, I must have completed a Master Promissory Note and Loan Entrance
Counseling at www.studentaid.gov.
I FURTHER UNDERSTAND THAT AM RESPONSIBLE FOR REPAYMENT OF THIS ADVANCE IF, FOR ANY
REASON, (INCLUDING MY DROPPING A COURSE, NOT ATTENDING A COURSE, OR WITHDRAWING FROM
COLLEGE) FINANCIAL AID FUNDS ARE NOT DISBURSED TO MY ACCOUNT.
I agree that by registering for courses within the Community College System of New Hampshire (CCSNH), I am financially
obligated for ALL costs related to the registered course(s). Upon a drop or withdrawal, I agree that I will be responsible for all
charges as noted in the student catalog and handbook. I further understand that if I do not make payment in full, my account
may be reported to the credit
bureau and/or turned over to an outside collection agency. I also agree to pay for the fees of any
collection agency, which may be based o
n a percentage of the debt up to a maximum of 35%, and all additional costs and
expenses, including any protested check fees, court filing costs and reasonable attorney’s fees, which will addnificant costs to
my account balance. I understand that I am also responsible for payment of the advance amount indicated above if for any
reason financial aid funds are not disbursed to my account. Selecting ‘YesʰݶNjss’ indicates I have read and agree to these
statements.
Yes, I agree:
Signature: _________________________________________ Date: _____________________________
OFFICE USE ONLY
Credits: _______________________
Major: ________________________
SAPFA: _______________________
OS Processor: ________________
Date: _________________________
Tuition and Fees: _________________
Grants: _______________
Loans: _____________
___
Total Aid: ______________________
Anticipated Credit Balance: ____________________
AMOUNT APPROVED: _______________________
FAO ƻƻNJŷər^
Expiration Date: ____________________
