Certification Of Approval For Off-Campus Enrollment printable pdf download

STANFORD UNIVERSITY • FINANCIAL AID OFFICE • MONTAG HALL • 355 GALVEZ ST • STANFORD, CA 94305-6016

CERTIFICATION OF APPROVAL FOR OFF-CAMPUS ENROLLMENT

Federal and state regulations permit the Financial Aid Office (FAO) to offer federal Pell Grant, Direct Loan, Direct PLUS Loan, and/or Cal Grant

funds to assist Stanford students with the cost of courses taken elsewhere which can be applied toward your Stanford degree program. University-

administered aid funds (Stanford scholarship, federal SEOG grants, federal Perkins loans, and Stanford institutional loans) are not available to

cover the cost of courses taken elsewhere.

Please complete both sides of this form, including obtaining approval from the Registrar’s Office, and return the completed form to the FAO.To

ensure timely delivery of your aid funds, please submit this form at least 8-10 weeks before your enrollment at the Host Institution begins or

before payment for the program is due. Course units earned at the Host Institution must be successfully transferred to Stanford within 90 days of

completion of your enrollment at the Host Institution.

Name

Stanford ID#

Social Security #

Mailing Address

Local Phone Number

E-Mail Address

Permanent Address

Permanent Phone Number

Current Class Level

Host Institution, Program Name, Location

Title IV School Code (Required)

Complete Mailing Address

Program Administrator

Phone Number

E-Mail Address

COURSES FOR WHICH YOU PLAN TO ENROLL

Official Course Title

UNITS

Official Course Title

UNITS

_____________________________________________________

Please read and sign:

I understand that my federal and/or state financial aid for enrollment at the Host Institution is contingent upon successful completion of the above courses. In

addition, I recognize that these course units must be transferred to Stanford University to be applied toward my degree programwithin ninety days of the end of my

enrollment at the Host Institution. I understand that if my units are not successfully transferred within the ninety-day period, my financial aid for the enrollment

period will be retroactively canceled; I will be responsible for immediate repayment of all funds received, and my future registration at Stanford will be placed on

hold until all funds have been repaid.

STUDENT SIGNATURE

DATE

____________________________

TO BE COMPLETED BY CREDIT EVALUATOR, REGISTRAR’S OFFICE

THE ABOVE NAMED SCHOOL IS AN ACCREDITED INSTITUTION:

YES:_______

NO:_______

THE COURSES TO BE TAKEN ARE TRANSFERABLE:

YES:_______

NO:_______

THE COURSES TO BE TAKEN, WHEN COMPLETED, WILL TRANSLATE INTO _______ QUARTER UNITS AT STANFORD.