2013 Request Form For Extension Of Financial Aid (Page 2 of 2) in pdf

Request for Extension (Summer Quarter 2013): All appointment slots in the Counseling and Advising Center have been filled. Students will

need to wait until October 7, 2013 to schedule appointments

If you are part of a special program such as DSS, EOPS, OTI or SSRS please

go and see your counselor there. These programs offer services throughout the Summer.

DE ANZA COLLEGE

FINANCIAL AID OFFICE

21250 Stevens Creek Blvd.

Cupertino, CA 95014-5793

REQUEST FOR EXTENSION for FINANCIAL AID

Name: __________________________________ SID#: ___________________

Date: _________________________

Email Address: ____________________________ Phone #’s: ________________________________________________

What is your major? _________________________________________________________________________________

What is your Educational Goal at De Anza College?

 Certificate

 Associate Degree

 Transfer

 Other: ____________________________________________

If you plan to transfer, what school will you be attending? ___________________________________________________

Note: You can apply for an extension ONE TIME ONLY!

Note: You MUST COMPLETE each step below BEFORE scheduling an appointment in Counseling!

(Check box  when you complete each step)

Step 1: 

Pell Grant/Loan Maximums: Go to What is your total percentage of Pell

Grant used to date? _________ (Max is 600%) What is your total student loan debt? _____________. (Sub Max is $23K).

TRANSFER STUDENTS: how many years of Financial Aid eligibility would you like to have left after you transfer to earn

your Bachelor’s degree? ________ (FYI - After 3 years, only about 53% of transfer students have earned their BA/BS).

Step 2: 

Transcript Evaluation: If you have transcripts from other schools, turn in sealed, official transcripts to

Admissions and Records and request an evaluation and allow at least two months for the evaluation. You must wait to

receive the confirmation they have been evaluated BEFORE scheduling an appointment in Counseling.

Step 3: Testing: If you need to take placement tests, you will need the results of these tests BEFORE scheduling an

appointment in Counseling. It can take up to three weeks to get the results.

Step 4: List all prior colleges, schools, and/or universities you have attended.

College

Dates Attended

Units Attempted

Units Earned

Degrees Earned

__________________________________________________________________________________________________

Step 5:  Make an educational plan: either in Degree Works or hand written that shows specifically, which courses, by

quarter, you need to take to complete your educational goal.

Step 6:  Personal Statement: Please, list specifically and completely all the reasons WHY you have not completed your

educational goal and WHY you need this extension (attach additional pages as needed).

CERTIFICATION: I certify that all information on this application is true, complete and accurate to the best of my

knowledge. I understand that I must stick to the courses on my educational plan, make satisfactory academic progress, and

can only apply once for an extended time frame.

Applicant's Signature ______________________________________ Date _____________________________________

2013 Request Form For Extension Of Financial Aid Page 2

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