Office of Financial Aid & Scholarships Graduate PLUS Loan Request
SSB Bldg #121 – First Floor
2019-2020 Aid Year
3801 W. Temple Ave; Pomona, CA 91768-4008
Phone: (909) 869-3700
Fax: (909) 869 - 4757
Student Name: __________________________________________Bronco ID Number: ____________________
Student Borrower Information
SOCIAL SECURITY NUMBER_________________________________ DATE OF BIRTH____________________________
STREET ADDRESS_____________________________________________________________________________________
CITY________________________________________________________ STATE________ Zip Code________________
ACADEMIC PROGRAM ENROLLED IN FOR 2019 – 2020 ______________________________________________________
Loan Request: For the 2019 – 2020 Academic Year (August 22, 2019 – May 15, 2020)
Enrollment Period: 2019 – 2020 Academic Year Fall 2019 Only Spring 2020 Only
Requested Loan Amount: Maximum PLUS Eligibility OR PLUS Loan Amount $_______________
Cal Poly Pomona reserves the right to award less than the requested amount based on the student’s eligibility.
Before requesting a loan amount, please note the yearly Federal Direct Unsubsidized loan limits, as you should borrow
your maximum Federal Direct Unsubsidized loan eligibility first:
Maximum Annual Direct Unsubsidized Loan Eligibility
Graduate Students (Pursuing a Master’s or Doctoral degree) $20,500 Unsubsidized Stafford Loan
Your maximum Unsubsidized Loan eligibility may be less than the above amount; loan eligibility is based upon your cost of attendance
minus all other types of financial aid. To determine your Grad PLUS eligibility, subtract any amounts of financial aid you will be receiving
(including Unsubsidized Loans) from your Cost of Attendance. The resulting figure will be your maximum Grad PLUS eligibility;
you do
not have to borrow the maximum amount.
PLUS Loan Denial Options (In the event the PLUS loan is credit-denied. Please check only one)
Use an endorser (credit-worthy co-signer) or contest the credit denial. I understand it is my responsibility to contact the Direct
Loan Servicer at 1-800-557-7394 to obtain the necessary paperwork, and that I will be required to complete the PLUS Counseling
Module on www.studentloans.gov
.
Cancel the PLUS request. I will pursue other options.
Student Borrower’s Consent & Signature
1. I have read, and understand, the attached Graduate PLUS Loan Information Sheet and the attached Privacy Disclosure Notice.
2. I consent to the U.S. Department of Education and its agents obtaining a report of my credit record and using that information
in determining whether to make a Federal Direct PLUS Loan to me. I understand that the Department of Education will notify
me in writing of the results of the credit check with respect to my loan application.
3. I must be enrolled at least half-time and making Satisfactory Academic Progress towards my degree in order to receive funds
from a Graduate PLUS Loan.
4. I understand that I MUST complete a Graduate PLUS Loan Entrance Counseling session
AND have a signed Graduate PLUS
Loan Master Promissory Note (MPN) on file with the U.S. Department of Education to complete the loan process (the Entrance
Counseling & MPN can both be completed at www.studentloans.gov
).
Student Signature_____________________________________________ Date__________________________
Return This Form by FAX to (909) 869-4757
