Federal Direct Parent Plus Loan Application And Credit Authorization
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1Federal Direct Parent PLUS Loan
Application and Credit Authorization
To apply for the Federal Direct Parent PLUS loan you must complete all sections of this loan application. This form must be
completed each academic year to request a PLUS loan through Bluefield College. The Free Application for Federal Student Aid
(FAFSA) must be submitted each academic year before a PLUS loan application can be processed.
The information you supply on this application will be electronically transmitted to the U.S. Department of Education, its servicers
and/or agents. Your credit history will be reviewed to determine your eligibility. Please print using black or blue ink. If you leave a
section blank, this form cannot be processed.
Student Information
Last name:
First name:
Student ID Number:
Student Type (Check one):
Student SSN:
Date of Birth (Month/Day/Year):
Traditional
Online Programs
I would like the loan applied during the following semester(s):
Academic Year: 2016-2017
(Check one):
Fall / Spring
Fall / Spring / Summer
Fall only
Spring only
Summer only
List the name of one parent borrower only. In order to apply for a PLUS loan, the borrower must be a natural parent,
adoptive parent, or stepparent (if stepparent’s income and assists are considered on the FAFSA) of the dependent student
(dependent by FAFSA definitions, not IRS dependency definitions).
Parent Information
Last name:
First Name:
SSN:
Street Address (P.O. Box # alone is not acceptable unless there is no street delivery)
City
State
Zip
Date of Birth (Month/Day/Year)
Phone Number (Home)
Phone Number (Work) or (Alt/Cell)
Are you a U.S. citizen?
Yes
No
If No, list Alien Registration#: ___________________________
E-mail Address:
Loan Amount Request
List the amount you wish to borrow: $
(DOLLAR amount is required)
Title IV (Federal) Authorization Information
If your student’s federal financial aid combined with your PLUS loan exceeds the cost of tuition, fees, room, board, the college must obtain your
permission to use your PLUS loan funds to pay charges other than those listed above. Examples of other charges that your student may incur are:
health insurance and parking fines.
Please indicate your choice below:
I authorize Bluefield College to pay charges other than tuition, fees, room and board using my PLUS loan
proceeds. This may include a maximum of $200.00 in prior academic year charges.
I do not authorize Bluefield College to pay charges other than tuition, fees, room and board using my PLUS loan proceeds and I
understand that my student will be responsible for payment of these charges as billed.
Authorization of Credit Check/ Consent to Obtain Credit Report
I consent to having the U.S. Department of Education and its agents review my credit report and use the information from that report in
determining whether to award a Federal Direct PLUS loan to me. I understand that I will be notified in writing of the results of the credit check. I
understand that the credit check is valid for 60 days only, and if the loan is not processed within that time, another credit check will be required. I
attest that I have read and agreed to all the information include with this form, including the Privacy Act Disclosure Notice.
Parent Signature
Date
BC Central Office 3000 College Avenue Bluefield, VA 24605
Phone 276-326-4215 Fax 276-326-4356 Email: bccentral@bluefield.edu
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