Rev. March 14, 2019
6. Do you have more than one conviction for selling illegal drugs? Only count convictions for offenses that
occurred during a period of enrollment for which you were receiving federal student aid (grants, loans and/or
_____ YES - Please sign and date the end of this form. You are done.
_____ NO - Go to question 7.
7. Write the date of your last conviction for possessing illegal drugs here: ______________________
If you have no convictions for possessing drugs, skip to question 9 on this worksheet.
8. If you have only one conviction for possessing drugs, add one year to the date in question 7, and write that date
If you have two convictions for possessing drugs, add two years to the date in question 7, and write that date here:
9. Write the date of your last conviction for selling illegal drugs here: _______________________
If you have no convictions for selling drugs, skip to questions 11 on this worksheet.
10. If you have only one conviction for selling drugs, add two years to the date in questions 9, and write that date here:
11. Look at the dates you wrote in questions 8 and 10. The later of the two dates listed below is your eligibility date.
If there is only one date, copy that date here: ____________________________
If there are two dates, write the later one here: ___________________________
I certify that the above statement is true and complete to the
best of my knowledge. I also understand that falsification of
information on my part may result in the loss of Financial Aid.
It is the policy of this College that no person, on the basis of race, color, religion, gender, national origin, age, disability,
sexual orientation, or veteran’s status, shall be discriminated against in employment, in educational programs and
activities, or in admission. Inquiries and complaints may be addressed to the Compliance Officer, Diversity Department.