Student Intake Form Page 2
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2Appointment Date/ Time/ With: ______________________________________________________________________________________________
General Notes:
General Loan Information
Time Line:
Servicers:
Grace starts:______________________________________________
Private Loans:_________________________________
Repayment starts:_________________________________________
___________________________________________________
IBR Start Date:____________________________________________
Federal Loans:_________________________________
Consolidation Start Date:____________________________________
___________________________________________________
Deferment/Forbearance Start Date: ___________________________
Loan amounts:
Plan A:_________________________________________
Private Loan Total:______________________________
1._______________________________________________________
2._______________________________________________________
Federal Loan Total:_____________________________
Plan B:_______________________________________
Perkins:_______________________________________
1._______________________________________________________
Other:________________________________________
2._______________________________________________________
Forms Completed: ISD
ECF
Teacher LF
IDRPR
Consolidation
EH/UnEmply Def
Budget
Other:_________________________________________________________________________________________________
Phone Calls Made: Fed Loan
Navient
Great Lakes
NelNet
SAF
Collections
Other:_________________________________________________________________________________________________
Websites Visited: FSA ID
NSLDS
MUS
Repay. calc.
Servicers
SLConsolidation
Other:_________________________________________________________________________________________________
Links to send:_______________________________________________________________________________________________
Forms to send:______________________________________________________________________________________________
Patrons next steps/tasks to be completed:
1._________________________________________________________________________________________________________
___________________________________________________________________________________________________________
2._________________________________________________________________________________________________________
___________________________________________________________________________________________________________
3._________________________________________________________________________________________________________
___________________________________________________________________________________________________________
SIDE TWO FOR OFFICE USE ONLY
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