2012-2013

Financial Aid Revised Information Summary

1. Student's ID Number:        

2. Student's Name:        

3. New Student: Admitted to -select- fall trimester 2012 spring trimester 2013 summer trimester 2013     Continuing Student

4. Graduate Student     Credential Student     Undergraduate

5. If a new student, list most recently attended college or university. Please indicate enrollment period. Example: Alpha College (mm/yyyy to mm/yyyy):
from ( / ) to / )

6. Will the student receive any of the following scholarships or other assistance?
-select- Ameritas Grant Ameritas Scholarship Community Patnership Discount Early Childhood Education Scholarship Ed.D. Scholarship Education Leaders Scholarship Employer Tuition Assistance Firefighter Scholarship MBA Scholarship Military Tuition Assistance Nursing Scholarship Online at Ground Rate Discount Outside Scholarship Tuition Remission Vocational Rehab (Cal Grant Recipients Only) Yellow Ribbon Award Other (describe in comments below)

7. If the student is receiving any of the scholarship/tuition assistance listed above, please indicate the dollar amount per term:

8. Number of units student will be taking beginning in fall 2012 and ending summer 2013:

10. Comments:

11. Completed by at the Campus.