Name of Student Financial Aid Applicant (please print):
Office of Financial Aid
301 Platt Boulevard Last First Middle
Claremont, CA 91711
Office: (909) 621-8055 Social Security Number:
Fax: (909) 607-7046
Email : firstname.lastname@example.org
Cal Grant B Access Authorization Form
Dear Cal Grant B Recipient:
According to the California Student Aid Commission regulations, Harvey Mudd College must
have a student’s written authorization to credit Cal Grant B Access funds to the student’s account.
Without this authorization, Harvey Mudd College must release these funds directly to the student.
A student has the ability to reverse his or her authorization prior to the disbursement of funds and
receive the Cal Grant B Access funds directly. Cal Grant B Access funds will be credited to your
student account or released directly to you once your award has been confirmed.
Read and complete the following:
I have read and understand the explanation above given by Harvey Mudd College’s Office of
Financial Aid regarding my Cal Grant B Access funds.
Check only one option:
I authorize the Student Accounts Office at Harvey Mudd College to apply my Cal Grant
B Access funds to my student account. I understand this authorization is valid until I
rescind it in writing.
I do not authorize the Student Accounts Office at Harvey Mudd College to apply my
Cal Grant B Access funds to my student account. Please release the Cal Grant B Access
funds directly to me.