Evergreen Valley College – Financial Aid Office 3095 Yerba Buena Road San Jose, California 95135 (408) 270-6460 DATA SHEET 2009-2010 Name: Student ID: Phone (Home or Cell)#: E-Mail: A. STUDENT INFORMATION 1. Have you been awarded financial aid at any other college or trade school for the 2009-2010 academic year? Yes No If yes, list name of school: 2. Have you been awarded scholarship funds for the 2009-2010 academic year? Yes No If yes, list amount and source 3. Will you receive Veteran’s Educational Benefits for the 2009-2010 academic year? Yes No If yes, indicate amount per month $ , and for how many months 4. Did you EVER attend any college, trade school or university in the United States OR in another country after high school other than EVC or SJCC? Yes No If yes, how many transferable units* can you use toward your goal at EVC? Did you receive a degree, diploma, a certificate, or complete a program? Yes No List the degrees, diplomas, or certificates 5. What is your academic goal? (Check only ONE) AA/AS Degree Transfer to a four-year university Certificate Other List certificate program B. STUDENT SIGNATURE I certify that all information on this form is true, complete, and accurate. I understand that false statements or misrepresentations will be cause for denial, reduction, or repayment of financial aid. By signing this form I agree to the following: o I consent to have any outstanding San Jose Evergreen Community College District charges for the 2009- 2010 school year deducted from my financial aid disbursement; o I am responsible for meeting with a counselor to determine my educational program and develop an education plan; o I must notify the Financial Aid Office of any changes in my program/major or my enrollment status; and o I understand that changes to my enrollment status may affect my eligibility for aid and I may be required to repay financial aid funds as a result of dropping a course or withdrawing from school. ________________________________________________________ ______________________ Student Signature Date Transfer units must be evaluated by a SJECCD counselor to determine how many units you can use toward your goal at EVC. These units are used in the maximum time frame calculation. Refer to the Satisfactory Academic Progress policy in the EVC Financial Aid Handbook. Certificate programs must provide at least 16 units of instruction. Including, but not limited to Health Center, Library, A.S., Financial Aid, material fees, EOP&S, Enrollment and/or Non-Resident fees.
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