Federal Direct Parent Plus Loan Request Form Page 2
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1
2Office of Student Financial Aid
Summerville Campus
2500 Walton Way, Augusta, GA 30904
Phone: 706-737-1431 Fax: 706-737-1777
FEDERAL DIRECT PARENT PLUS LOAN REQUEST FORM
To apply for the Parent PLUS loan, please visit
to begin the PLUS Request Process. The U.S. Department of
Education will perform a credit check to determine your eligibility. If you are approved, you must then complete this form and submit it to
the Financial Aid Office. By signing this form, you are attesting that you have read and agree to all the information on the front of this
form. A Parent PLUS loan borrower must also complete a Master Promissory Note (MPN) online at .
I. STUDENT INFORMATION: (please print clearly)
Last Name: ________________________________________ First Name: _______________________________ MI: ________
Student ID: ______________________________ Email Address: _________________________________________@ gru.edu
Street Address: _____________________________________________________ Phone: ______________________________
City: ___________________________________________ State: _____________________ Zip: _______________________
II. PARENT INFORMATION: (please print clearly).
The parent who completes this application must be the parent who completes the Master Promissory
Note. To apply for a PLUS loan, the borrower must be a natural parent, adoptive parent or stepparent (if stepparent’s income and assets are considered on the FAFSA)
of a dependent student.
Last Name: _______________________________________ First Name: ______________________________ MI: _________
Parent’s SSN: _________________________ Date of Birth: ___________________ Phone: ____________________________
Street Address: _______________________________________________________ City: ______________________________
State: ___________________
Zip: ________________ Email Address: ___________________________________________
Driver’s License #: __________________________________________ State: _______________________________________
Citizenship Status:
US citizen or eligible non-citizen
Non-citizen
Alien Registration #: _____________________
Are you in default on any Federal Parent/Student Loans?
Yes
No
III. LOAN PERIOD: select the loan period you wish to apply for
Fall / Spring: August 2013 through May 2014
Fall Only: August 2013 through December 2013
Spring / Summer: January 2014 through July 2014
Spring Only: January 2014 through May 2014
Fall / Spring / Summer: August 2013 through July 2014
Summer Only: May 2014 through July 2014
IV. Indicate the loan amount requested for the 2013-2014 academic year:
$
.00
1st Request
Additional Request
V. PARENT REFUND AUTHORIZATION:
If the loan proceeds exceed the applicable charges, a refund will be issued to the parent, unless the parent authorizes it to
be given to the student.
If a credit balance results from the Parent PLUS Loan, do you authorize Georgia Regents University to release the refund to
your student?
Yes
No
Parent’s Signature ____________________________________________________
Date ____________________________
School use only: COA________________ - Other Aid Received _______________ = Max PLUS Eligibility: _____________________
Aid Year: __________________
Date Processed: ________________
PLUS Loan Amount Awarded: ___________________
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