Yuba Community College District
Financial Aid Offices
Reinstatement of Financial Aid for 2020-2021
_____________________________________________________ _______________________________
Last Name First Student ID
_____________________________________________________ _______________________________
Mailing Address Phone Number (Include area code)
_____________________________________________________
City State Zip Code
STUDENT: Complete this section.
1. I previously declined my financial aid at Yuba College/Woodland Community College during the 2020-2021 academic
year and am requesting reinstatement of my financial aid award(s) for the following terms(s):
Fall 2020 Spring 2021 Summer 2021
2. Institution/School Information - Please check the box that applies below:
I have NOT attended another institution during the 2020-2021 academic year.
I have attended another institution during the 2020-2021 academic year.
Name of institution attended: _____________________________________________________________
Term(s) Attended: Fall 2020 Spring 2021 Summer 2021
Attached is confirmation/proof of canceled awards from the other institution.
Note: You can only receive financial aid from one school at a time per term in a given academic year. If you have attended
another institution and received financial aid at that institution, you must decline financial aid at the other institution before
we can consider reinstating your financial aid awards.
Certification: I have read and understand the information stated on this form. I certify that the information provided on this form is
true and correct to the best of my knowledge. I understand that this information will be used to determine my eligibility and that false
or misleading information may be cause for denial, termination, and/or repayment of financial aid funds.
_________________________________________________ _______________________________
Student Signature Date
FINANCIAL AID OFFICE USE ONLY
Reinstatement Approved: Pell FWS FSEOG CAL B/C CCCG FTSSG EOPS CARE
Scholarship(s) Other: ___________________________________________________________________________
Reinstatement Denied: _____________________________________________________________________________
___________________________________________________________________________________________________
______________________________ ___________________
Financial Aid Signature Date
03/27/20
Yuba College
2088 North Beale Road
Marysville, CA 95901
530-749-7999
Woodland Community College
2300 East Gibson Road
Woodland, CA 95776
530-661-5725
Lake County Campus
15880 Dam Road Extension
Clearlake, CA 95422
707-995-7923
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