Financial Aid Verification Form
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1FINANCIAL AID VERIFICATION FORM
STUDENT NAME: __________________________ STUDENT ID or SSN: ________________
SEMESTER: ___________
YEAR: __________
STUDENT FEES
1. Tuition and Fees
$ _________________
2. Meal Plan
$ _________________
3. Room & Board
$ _________________
4. Books
$ _________________
5. Other Fees _______________
$ _________________
TOTAL FEES
$ ________________
AMOUNT OF AID AWARDED
6. Pell Grant
$ _________________
7. Federal Grant
$ _________________
8. Federal SEOG
$ _________________
9. Federal ACG Grant
$ _________________
10. State Funded Grant
$ _________________
11. Other Grant _______________
$ _________________
12. ILP Assistance ______________
$ _________________
13. Scholarship ________________
$ _________________
14. Scholarship ________________
$ _________________
TOTAL AID
$ _________________
STUDENT BALANCE $ _________________
I certify that I am authorized to provide the above stated information on behalf of
____________________________________ and that the information provided is correct.
(college/university)
Print Name: ______________________________
Date: ____________________________
Signature: ________________________________
Title: ____________________________
Please include actual fees
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Parent category: Financial