Transfer Student Financial Aid Confirmation Form printable pdf download

Transfer Student Financial Aid Confirmation

Dear Student,

In order to determine your loan eligibility we are required to review your recent student loan history. Please answer

the questions below:

Yes No

Did you attend another institution in the last year?

Yes  No

If yes, did you receive financial aid at this school?

If the answer to both questions above is YES, then please print and sign your name below and have your previous

school complete the section below. Your previous institution will then return the form to the FL Tech Financial Aid

Office by fax: 321-724-2778. Your financial aid will not be reviewed until this form is complete and returned to

our office.

I, _____________________________(print name), give permission to my former school(s) to share the below

information with the Office of Financial Aid at Florida Institute of Technology.

Student Signature: _______________________________________________ Date: __________

The following information must be supplied by a Financial Aid Counselor at your previous school.

Student Information

Student Name: ________________________________________

SSN:____________________

Official Last date of Attendance:_______________

Official Academic Year End Date: ________________

Loan Information

Current loan period start and end dates:___________ to __________

Revised loan period end date___________

Gross Loan Amount(s) Disbursed- Minus any refunds to lender(s):

Subsidized: ____________

Unsubsidized:____________

Last Date of Loan Disbursement:_______________

Pell Disbursed for most recent aid year: Amount:_______________

Aid Year:_____________

School Certifying Official

Name (please print):______________________________________ Date:__________________

Signature of Financial Aid Officer:__________________________________________________

Name of institution: ______________________________________________________________

Address:________________________________________________________________________

City:___________________________________ State:________ Zip Code:________________

Phone:________________________

Email:_________________________________________

Transfer Student Financial Aid Confirmation Form