Cal Grant Gpa Verification Form - Caltech Financial Aid (Page 2 of 3) in pdf

Instructions for filling out the Cal Grant GPA Verification Form

STUDENT INFORMATION SECTION. Please print clearly using blue or black ink only. Filing deadline for 2014-15 awards is March 2, 2014

Your Social Security number: Enter your Social Security number (SSN) as it appears on your Social Security card and your FAFSA. (Valid SSNs

do not begin with 8, 9 or 000. If you believe your SSN begins with an 8, 9 or 000, then contact your local Social Security Office to verify your

number.) Individual Tax Identification Numbers (ITIN) are not accepted.

Month/year of high school graduation: Enter the month and year you graduated, or plan to graduate from high school. Enter the month in a

two-digit format (for example: January should be appear as “01”; November should appear as “11”). Enter the year in a four-digit format (for

example: 2014 should appear as “2014”).

Your name: Print your full name as it appears on your Social Security card. Enter last name, first name, middle initial.

Your date of birth: Enter your birth date. For example, June 25, 1996 would be entered as 06-25-1996.

Telephone number: Enter your area code and daytime telephone number.

Your permanent mailing address: Enter your permanent mailing address, city, state and five-digit zip code.

Your E-mail address: Enter a “safe” e-mail address where you can be contacted for questions. This is optional.

Submitting a test score instead of a GPA: Complete questions 1 through 10, sign the form and attach a photo copy of the testing organization’s

score report and mail by the deadline to Commission. TRANSCRIPTS and DIPLOMAS WILL NOT BE PROCESSED.

The results from the GED, SAT or ACT tests must be submitted in lieu of a GPA if:

You participated in a home schooling program or attended an unaccredited high school.

You attended a high school or college outside of the United States and are unable to have those grades converted to a 4.00 scale or your

school did not grade in a manner that can be readily converted to a 4.00 scale.

Students who have been out of school for five years can choose to submit either test scores or their GPA.

– Scores from the California High School Proficiency Examination (CHSPE) cannot be accepted in lieu of a high school GPA, but

passing the CHSPE does meet the high school graduation requirement of the Entitlement Cal Grant program. Also, grade re-

ports, transcripts, and other proficiency certificates WILL NOT BE ACCEPTED.

– Only scores from the SAT reasoning test WILL BE ACCEPTED. Subject test scores will NOT BE PROCESSED.

Spring school code: Enter the school code for the school at which you were in attendance for spring 2014. Students graduating from high

school in spring 2014 should write in the College Board high school code number for their high school. This is the same code used for send-

ing SAT score information to the high school. Students who will be in college for the spring 2014 school term should write in the federal

code number of the college you are attending in spring 2014. Students who are not in college or high school for the spring 2014 school term

should leave this section blank.

10. Student signature: By signing this form, you certify that you have read these instructions and that the information you provided is correct. It is

illegal to report false or misleading information on this form and doing so may result in any Cal Grant award being revoked.

Once you have filled out the student information, take the form to your school and request that they verify your GPA. Be aware that if your

school will be electronically submitting your GPA to the California Student Aid Commission, you do not need to submit this form. It is your

responsibility to verify that the school will be submitting your GPA for you.

FOR SCHOOL USE ONLY SECTION

(Optional) Please enter the 10-Digit State Student Identification Number (SSID) of

STATE STUDENT IDENTIFICATION NUMBER:

the student who’s GPA is listed on this form. If the student does NOT have a SSID,

please leave blank.

Fill in this bubble ONLY if the GPA is based on high school coursework.

GPA IS BASED ON HIGH SCHOOL COURSEWORK:

Fill in this bubble ONLY if the GPA being certified is based on at least 16 but less than

CALIFORNIA COMMUNITY COLLEGE RE-ESTABLISHED GPA:

24 units completed at a California Community College. If the GPA is based on college

units, and is not a reestablished GPA as described above, do not fill in any bubble.

High schools use their College Board school code; colleges use their USED OPE ID

GPA VERIFIER’S SCHOOL CODE:

Fill in ALL three GPA spaces. Cal Grant GPAs are calculated on a 4.00 scale. High Schools certi-

VERIFIED STUDENT GPA:

fying GPAs MUST be accredited or have a UC approved course list in order to verify GPAs. Stu-

dents not attending accredited high schools should provide either a GED, SAT or ACT score.

After the school completes the GPA information, we recommend making a copy for your records, and purchas-

ing a $1.20 Certificate of Mailing from the post office and mail to:

California Student Aid Commission

Cal Grant Operations

P.O. Box 419077

Rancho Cordova, CA 95741-9077

G-4 (09/2013)

Cal Grant Gpa Verification Form - Caltech Financial Aid Page 2

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