INTERNAL OFFICE USE ONLY
FAO VERIFIED (signature)
STUDENT FIRST NAME:
SOCIAL SECURITY #:
STUDENT MAIDEN NAME: (if applicable):
DRIVERS LICENSE NUMBER & STATE ISSUED:
NO POST OFFICE BOXES
HOME TELEPHONE NUMBER:
DO YOU HAVE A FACEBOOK ACCOUNT?
NAME LISTED ON FACEBOOK ACCOUNT:
NAME OF EMPLOYER:
WORK TELEPHONE NUMBER:
List FIVE family or friends with DIFFERENT Address/Telephone Numbers (Reference must be over 18 Years of Age)
FIRST & LAST NAME
Telephone Number with/Area Code.
List THREE People you would like to invite to your graduation ceremony. (Must be over 18 Years of Age)
I certify that the information I provided to the college on this page to be true. I authorize any organization or person, whether or not listed on this document, to provide or verify information to the college regarding my credit worthiness, address and telephone number of my residence or place of employment and any information regarding student loans, loan payments, deferments, delinquencies, loan consolidations or any other student loan information requested by the college, including information regarding consolidated loans even if one or more or none of the consolidated loans were not obtained through to attend the college. I hereby release the college and any organizations (including, but not limited to banks, financial institutions, student loan service agencies, guarantee agencies, the Federal Department of Education, credit bureau, etc.) or individuals from any liability for exchanging such information or providing such information to third parties.
Financial Aid Officer reviewing the above information:
Information Supplied by
June 30, 2022
Why does the educational institution request contacts?
Federal regulation states:
(xiii) Require the student borrower to provide current information concerning name, address, social security number, references, and driver’s license number and State of issuance, as well as the student borrower’s expected permanent address, the address of the student borrower’s next of kin, and the name and address of the student borrower’s expected employer (if known).
The personal and contact information collected at the time of exit counseling must be provided to the student’s loan servicer. A student authorizes his or her school to release information to lenders as part of the promissory note the student signs as part of the loan application process.
According to the 2010/2011 Department of Education Federal Student Aid Handbook, Volume 2, Chapter 6.
Important: Providing accurate and legible references is a requirement of Loan Counseling and to your benefit in the areas mentioned above. The references provided hold no responsibility and have no obligation (except in the case of a Parent PLUS Loan) in repayment of any student loans borrowed in your name.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Contact Sheet
Agree & Sign