PO Box 35236 Fayetteville, NC 28303-0236 PHONE (910) 678-8242 FAX (910) 486-3600
You indicated on your 2011/2012 Financial Aid Certification & Loan Application form that you do not
authorize Fayetteville Technical Community College to use your Title IV award dollars to pay for charges
other than tuition and fees. This means:
a. you may not charge your books at the book store, and
b. you may receive a refund check and still owe a balance on your
student account that is your responsibility
You may modify this authorization at any time. Any change is effective the date of the revised
authorization and is not retroactive. To modify your authorization please complete the section below and
return this form to the Fayetteville Technical Community College Financial Aid Office as soon as possible.
I authorize FTCC to use my Title IV program funds (Federal Pell Grant, Federal SEOG Grant, William D.
Ford Federal Direct Loan) to pay for the cost of attendance charges and other institutional charges, late
fees, etc. For example, if I check “Yes”, I can charge my book and required supplies in the FTCC
bookstore against my federal aid. I understand that I have the option of changing my mind at any time
and paying cash for anything other than tuition and fees.
(Please check “Yes” or “No”, sign, and date below)
Social Security Number Date
If you have questions concerning this authorization, please contact the financial aid office at (910) 678-
The Financial Aid Office
FTCC Form C-35 Revised 03/29/2011