RETURN TO FINANCIAL AID OFFICE:
Deadline Submission Dates:
Fall 2019 – October 14, 2019
Spring 2020 – March 9, 2020
Summer 2020 – June 22, 2020
2019-2020
Consortium Agreement Request
FSFA67, 68, 69
STUDENT INFORMATION
Last Name First Name M.I.
Student ID#
The Consortium Request is to approve enrollment from other Los Rios Colleges for further financial aid eligibility. Student
must be enrolled in one course at SCC and be meeting Satisfactory Academic Progress requirements. Only the course(s)
approved by a Counselor and meet an eligible SCC degree, certificate, or transfer program requirement will be considered
for approval. Complete the form; incomplete items will cause a delay or denial.
1. Semester you are requesting for: _____________________
2. Select the school granting my transfer, degree or certificate program (this is my home school): ARC/ CRC /FLC /SCC
3. Enter the Semester: ____________ and Year: ____________ you expect to complete your Transfer, Degree or
Certificate program at SCC.
4. List the units you want considered for your consortium request: ARC ______ CRC ______ FLC ______ SCC ______
5. How many current SCC units are NOT financial aid eligible? (Go to: eServices Financial Aid and select FA Course
Eligibility): ____________. Discuss these courses with a Counselor.
6. Student Acknowledgement and Certification: I understand that only the courses required
towards my program completion for transfer, graduation or a certificate program will be considered. If I am no longer
enrolled in the approved classes listed on my consortium at the time of review, the request will be null and void. I also
understand that it is my responsibility to decline financial aid from any college(s) for the same period I am receiving
financial aid at SCC.
Student Signature: __________________________________________ Date: ___________________
THIS SECTION TO BE FILLED OUT BY SCC COUNSELOR
Counselor’s Approval and Certification: After the review of the student’s Academic Plan/Major, I certify that
I have listed only enrolled courses from ARC/CRC/FLC that meet the student’s program requirements.
American River College
Course (et… Math 123) Units (3)
Cosumnes River College
Course (et… Math 123) Units (3)
Folsom Lake College
Course (et… Math 123) Units (3)
8. Student’s SCC major with Admissions and Records is: ________________________________________________
DO NOT WRITE BELOW THIS LINE – FOR FINANCIAL AID OFFICE USE ONLY
SCC U: _______ Combine U: _______ SAP Fall: ______ Spring: ______ Summer: ______ Status: FX 3/4x 1/2x <1/2X
Granted w/ARC: _______ FLC: _______ CRC: _______ Loan: Yes No
Postponed Date: _________________ Pending: ________________________________________ Deadline: ____________
Denied
Comments:________________________________________________________________________________________________
__________________________________________________________________________________________________________
FAO Staff: ______________________________ Date: ___________________
