Smith Aid Application/traditional U.s. Students (Page 2 of 2) in pdf

Student Assets:

Give details on student’s assets

Current Value

Cash and savings

__________

Uniform Gifts to Minors

__________

Stocks, bonds, CDs, and other investments

__________

Trust Funds

__________

B. List student's other assets (car, real estate, etc.):

Asset

Purchase Price

Date of Purchase

Current Value

_______________________________________________________________________________________

Outside Scholarships and Loans: (Policy can be found at )

If you expect to receive any outside scholarship or loan awards for 2016-2017 please complete the following information. Do not include

Federal Pell or state grants, Federal Direct or Perkins loans.

Name of award

Amount

Type (Scholarship or loan)

1. ___________________________________________________________________________________________

2. ___________________________________________________________________________________________

3. ___________________________________________________________________________________________

It is your responsibility to inform us of outside aid; if we learn of any outside awards after July 1, the grant portion of your award

may be reduced by the full amount of the award.

Student Account Authorization

I, the student, authorize Smith College to apply Federal Title IV financial aid funds to allowable institutional charges such as tuition,

room, board, and required fees and also to other educationally related expenses that might be posted to my student account.

Examples of other charges are computer software and equipment, optional health insurance charges and other medical expenses, late

payment fees and bad check fines, library fines and miscellaneous housing charges.

I understand that this authorization can be rescinded at any time by submitting a signed statement to Student Financial Services.

Authorization:

Yes _____

No _____

Statement of Eligibility

I certify that I, the student, am not in default on any Federal Family Educational Loan Program (Guaranteed Student Loan/Stafford Loan,

National Direct/Defense/Perkins Loan, or PLUS/SLS Loan) and that I do not owe a refund on any Federal Title IV - Higher Education

Act grant (Pell, Supplemental Educational Opportunity Grant or State Student Incentive Grant) for attendance at Smith College or any

other educational institution and I do not own property subject to a judgment lien for a debt owed to the United States.

I attest that the information provided is true and accurate to the best of my knowledge.

____________________________________ ___________

____________________________________ ____________

Your Signature (Student)

Date

Parent Signature

Date

If you are in default, or owe a refund, contact Student Financial Services immediately.

If you are not required to file a 2015 tax return, please complete a Non-Filer Statement found on our website at

S:FAOForms -Student UseForms 2016-17Smapp 1617-trad.doc

Smith Aid Application/traditional U.s. Students Page 2

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