PLUS Request Form
Step 1: Go to PLUS application (studentaid.gov)> Parent Borrowers > Complete the Loan Agreement for a PLUS Loan
(MPN). If Credit Review status is “Accepted”, proceed to step 2. If “Denied”, contact Financial Aid Office.
Step 2: Complete this form and submit it to the Financial Aid Office. PLEASE PRINT!
Student ___________________________________________ SSN _____________________________ DOB __________________
Parent ____________________________________________ SSN _____________________________ DOB __________________
Parent’s Street Address _________________________________________________________________________________________
(City, ST, Zip) ________________________________________________________________ Phone ___________________________
How much do you want to borrow for Summer 2020? $ ________________
Your PLUS loan will be credited to your child's school account to pay any unpaid charges. If the loan disbursement
amount exceeds your child's school charges, what do you want done with the excess PLUS loan funds? (Check one)
_____ Apply the PLUS funds to my son/daughter’s FDLTCC account and give them any balance.
_____ Apply the PLUS funds to my son/daughter’s FDLTCC account and mail any balance to me at the
address listed above.
I consent to the U.S. Department of Education (ED), its agents, and the Financial Aid Office Staff at Fond du Lac Tribal & Community
College obtaining a report of my credit record and using the information from that report in determining whether to make a Direct
PLUS Loan to me. I understand that I will be notified in writing of the results of the credit check with respect to my loan application.
Parent Signature (must be signed in blue or black ink, not electronically) Date
An affirmative action, equal opportunity employer and educator. This document is available in alternative formats to individuals with disabilities. Consumers with hearing
or speech disabilities may contact us via their preferred Telecommunications Relay Service. (April 23, 2019)
2101-14th Street Cloquet, MN 55720 | 218-879-0800 | www.fdltcc.edu | FAX: 218-879-0814
SCAN-EMAIL OR FAX OR MAIL THIS COMPLETED AND SIGNED FORM TO:
firstname.lastname@example.org -or- (218) 879-0814 -or- FDLTCC Financial Aid Office 2101-14th Street Cloquet, MN 55720