Fillable TCG 2019 2020 Application 20190628

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TCG 2019 2020 Application 20190628

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TCG App June 2019
Phone: (651) 642-0567
Toll Free: (800) 657-3866
Fax: (651) 642-0675
Minnesota Teacher Candidate Grant
Application
2019-2020
Instructions
Page 1
Read instructions before completing application. Incomplete applications will not be processed.
Return the application to:
Minnesota Teacher Candidate Grant
Minnesota Office of Higher Education
1450 Energy Park Drive, Suite 350
St. Paul, MN 55108-5227
Priority Deadlines
Fall 2019: August 16
th
, 2019 Spring/Summer 2020: December 13
th
, 2019
All awards are based on funds availability. Eligible students with complete applications on file by the dates above
will be considered for awards in the specified term. After all available funds have been awarded, completed
applications will be placed on a waiting list. Applications will still be accepted after these dates but students are
much less likely to be awarded.
Complete Application Checklist
In order for your application to be considered complete, your application must include the following:
Student Section including all the required information that is signed and dated
Completed Free Application for Federal Student Aid (FAFSA) or Minnesota Dream Act application
College or University Section completed by an authorized representative at the college or university you
attend that includes all of the required information
Program Information
The Minnesota Teacher Candidate Grant provides postsecondary financial assistance to eligible students enrolled
in Minnesota teacher preparation programs during one term in which the student is completing a required 12-
week or more student teaching experience. On a funds available basis, selected undergraduate and graduate
students may receive awards of up to $7,500. Applicants must intend to work in an identified shortage area
and/or belong to a racial or ethnic group underrepresented in the Minnesota teacher workforce to be eligible.
Eligibility
To be eligible, teacher candidates must, at a minimum:
• Be enrolled in a Minnesota teacher preparation program approved by the MN Professional Educator
Licensing and Standards Board (PELSB) that requires at least 12 weeks of student teaching in order for the
teacher candidate to be recommended for a Tier 3 license;
• Intend to teach in an identified shortage area or belong to a racial or ethnic group underrepresented in the
Minnesota teacher workforce (see www.ohe.state.mn.us/teachercandidategrant for details);
• Be meeting Satisfactory Academic Progress (SAP) requirements as defined by the institution;
• Complete a Free Application for Federal Student Aid (FAFSA) or MN Dream Act application for aid year; and
•
Demonstrate financial need.
Questions??
• If you need assistance filling out this application or have any questions, please contact us at:
Telephone Number (800) 657-3866 or (651) 642-0567
• You can also submit email inquiries to info.ohe@state.mn.us.
•
Be sure to specify your inquiry is related to the Minnesota Teacher Candidate Grant Program.
TCG App June 2019
Phone: (651) 642-0567
Toll Free: (800) 657-3866
Fax: (651) 642-0675
Minnesota Teacher Candidate Grant
Application
2019-2020
Instructions
Page 2
Important Information
•
Grants are awarded, in part, based on the date your application is complete.
• A percentage of award funds are reserved for eligible applicants who belong to a racial or ethnic group
underrepresented in the Minnesota teacher workforce.
• Teacher Shortage Areas are annually identified by PELSB and include shortage areas based on the license field
and the location where the applicant intends to teach after receiving license.
• Recipients who do not complete the student teaching experience may be required to repay the award and if
possible, recipients should contact the financial aid office before withdrawing.
Teacher Licensure Field – Question 17 of the application
List the teacher licensure field(s) in which you will be recommended for a Tier 3 license after completing the
student teaching experience during the term you are applying for the grant. Examples: Elementary Education,
Special Education: Academic and Behavioral Strategist, Communication Arts and Literature, etc.
Notice to Applicants
Alternate Format Available
The Office of Higher Education does not discriminate on the basis of disability in the admission or access to, or treatment or
employment, in its programs or activities. This document can be made available in an alternative format to individuals by
calling (800) 657-3866 or (651) 642-0567.
Social Security Number
Section 7(b) of the Federal Privacy Act of 1974 (5 U.S.C. 552a) requires that when any federal, state, or local government
agency asks you to disclose your Social Security Account number, you must be advised whether that disclosure is mandatory
or voluntary, by what statutory or other authority the number is solicited, and what uses will be made of it. The Social
Security number will be used by the Minnesota Office of Higher Education (MOHE) to verify your identity, and as an
identifier of your file in order to record necessary data accurately. As an identifier, the Social Security number is used in the
Teacher Candidate Grant program for such purposes as processing the application form, program evaluation, and reporting.
You are being advised that disclosure of your Social Security number is voluntary. However, failure to submit your Social
Security number may prevent further processing of this form.
Use of Data
Pursuant to Minnesota Statutes, Sec. 13.04, subd. 2, you are hereby informed that the information supplied in this form may
be used as follows: (1) in the processing and verification of the data supplied to determine your eligibility for this program;
and (2) for compilation and analysis of summary data relative to this program. Private data, including identifying
information, will not be disclosed under Minnesota Statutes, Sec. 13.32, unless otherwise stated by statute or at the request
of the Legislative Auditor. You are not required to provide the information supplied in this form. However, failure to submit
requested data may prevent further processing of this form. The information supplied in this form may be shared with other
public and private individuals and entities in order to use the information for the purposes specified above.
Family Education Rights and Privacy Act of 1974 (FERPA)
FERPA pertains specifically to education records of students, affording them certain rights with respect to those records.
Education records are records that directly relate to a student and are maintained by an institution or a party acting as an
institution. FERPA applies to all educational agencies and institutions that receive funding under most programs
administered by the Secretary of Education (34 C.F.R. 99.1). Almost all postsecondary institutions, both public and private,
generally receive such funding and must comply with FERPA. Under FERPA, students are given three primary rights: (1)
inspect and review their education records; (2) have some control over the disclosure of information from their education
records; (3) and seek to amend incorrect education records.
TCG App June 2019
Phone: (651) 642-0567
Toll Free: (800) 657-3866
Fax: (651) 642-0675
Minnesota Teacher Candidate Grant
Application
2019-2020
Application
Page 1 – Student Section
Application Info
1. Check the term for which you are applying to receive this grant (you must be completing
an eligible student teaching experience in this term to be eligible for an award)
Fall 2019
Spring or Summer 2020
Student Info – All Information Required
2. Name (Last, First, Middle)
3. Social Security Number
4. Mailing Address
5. E-Mail Address
6. City
7. State
8. Zip Code
9. Telephone Number
( ) -
10. Permanent Address (if different from mailing address)
11. City
13. Zip Code
14. College or University
Race and Ethnicity – Optional
Questions in this section are optional however teacher candidates who belong to a racial or ethnic group underrepresented
in the Minnesota teacher workforce are given priority in the awarding process.
15. Are you Hispanic or Latino? Yes No
16. Select one or more of the following races:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Teacher Licensure Field and Student Teaching Experience Placement Info – Optional
Questions in this section are optional. If you are selected for an award, your college or university will be required to provide
the information before any payment.
17. Teacher Licensure Field (See Instructions)
18. School/Location
STUDENT CERTIFICATION AND PERMISSION FOR RELEASE OF INFORMATION
Please check the box next to each statement indicating that you understand the statement:
I give permission to my college and MOHE to verify the information provided on this application and to obtain
information for all funding sources relating to this application.
I give permission to my college and/or MOHE to enter the information from this application onto the web-based
application on my behalf.
I certify that the information on this application is true and correct and I promise to provide additional documentation if
requested. I promise to provide a written report to MOHE of any changes.
I understand this form is used to establish eligibility for this program and that if I purposely give false or misleading
information on this form, I may be subject to a fine, prison sentence or both; and such action may result in the forfeiture
of future awards from this program.
I understand that any changes in my FAFSA, MN Dream Act Application, Pell Grant, MN State Grant, or other state or
federal financial aid may cause my grant award to be adjusted.
I understand that all awards are subject to the availability of funds.
I certify that I have read and understand the Notice to Applicants section in the form instructions.
Applicant Signature
Date
TCG App June 2019
Phone: (651) 642-0567
Toll Free: (800) 657-3866
Fax: (651) 642-0675
Minnesota Teacher Candidate Grant
Application
2019-2020
Application
Page 2 – College or University Section
Student Info
Student Name
Social Security Number (last 4 digits)
College or University Name
Federal School Code
Financial Aid Office Verification of Student Status – All Information Required
Is the student a Minnesota Resident Student for State Financial Aid
purposes? (Student does not have to be a Resident Student to be
eligible. Information will be used for program evaluation)
Yes No
Is this an initial or updated version of this form? Initial Updated
Current degree student is seeking: Bachelor’s Graduate/Master’s Post-Baccalaureate
Current Student FA Eligibility Status: Eligible Academic Suspension In Default on Federal or State Loan Other
Academic Information – Information Required for Payment
In which teacher licensure field(s) will the student be recommended for a
Tier 3 license after completing this student teaching experience?
Location of the student teaching experience? (if not located in MN, also
list state and/or country of the placement location)
Financial Aid Office Student Budget Data – All Information Required
Important:
Only include information for 1 term in which the applicant is completing an eligible student teaching experience.
List grants, scholarships, and institutional aid the student is receiving or expected to receive.
Do not list state or federal work-study or federal, state, or private loans.
Term
Fall 2019 Spring 2020 Summer 2020
Start and
End Date
From: To: Title IV Cost of Attendance (COA) for this term: $
Resources
(Term Only)
Parent Contribution:$ Student Contribution: $ Total Resources (EFC): $
Assessed Need (COA – EFC) $
Pell Grant $
SEOG $
MN State Grant $
List all other federal, state, college, institutional, private, or other
grants and scholarships the student is receiving or is expected to
receive. Include the name of each grant/scholarship. Do not
complete if student has not completed the FA process at your
institution.
$
$
$
$
IMPORTANT: If balance is $0 or negative, student is not eligible to receive an award Balance: $
Financial Aid Office Certification
College or University Authorized Representative Name:
Signature
Date
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TCG 2019 2020 Application 20190628

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Completed 22 July 2020

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