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					                NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                                Post Office Box 13663, Research Triangle Park, NC 27709-3663

 NORTH CAROLINA LEGISLATIVE TUITION GRANT (NCLTG) INSTITUTIONAL CERTIFICATION & INVOICE
                                                         J & W FALL FORM


NAME OF EDUCATIONAL INSTITUTION                                                                                ACADEMIC YEAR

READ REVERSE SIDE INSTRUCTIONS BEFORE COMPLETING THIS FORM. TRANSMIT ONE COPY OF YOUR
ELECTRONIC ROSTER OF ELIGIBLE STUDENTS TO NCSEAA AND RETAIN ONE COPY FOR YOUR FILES.

The institution listed above, which entered into a Participation Agreement with the NCSEAA, hereby submits a request for NCLTG
payment on behalf of and to the credit of the eligible students listed on our electronic roster submitted on ____________________.
                                                                                                                          (mm/dd/yy)
1. This Fall Term invoice is submitted as of October 1, 2006. Invoice is due to SEAA by October 20th.

2. First classroom day of the school term for this invoice is _______________________________.
                                                                                             (mm/dd/yy)
3. Eligible students invoiced :



                Number of Eligible Students Awarded On Campus                                                                              a.


                Number of Eligible Students Awarded Off Campus                                                                             aa.



                Total Number of Eligible Students Invoiced for Fall 2006

I certify to the NCSEAA that to the best of my knowledge and belief each student, listed on our electronic roster, was enrolled at
this institution on October 1 in the case of the first academic term of the current school year or on the tenth classroom day of any
other term of the current school year as indicated above, and each student listed filed the NCLTG application with this institution, met
all residency, academic classification, minimum academic load, and other eligibility requirements of the laws of North Carolina
and the Rules Governing the NCLTG for the current school term.

I further certify that the NCLTG amount received by this institution from the NCSEAA on behalf of and to the credit of each student
listed on our electronic roster will upon receipt be credited to the respective student's account established with the business
office at this institution pursuant to the NCSEAA regulations governing the NCLTG Program.




Typed or Printed Name of Chief Executive Officer                    Signature of Chief Executive Officer




Sworn to and subscribed before me this ______ day of __________________, 20______.




Notary Public                                         Seal or Stamp


NCSEAA NCLTG J & W Fall Form 7/06
                 NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                           Instructions for Submitting Certification and Invoice Forms and Electronic Rosters
                                        for the North Carolina Legislative Tuition Grant (NCLTG)
J & W Fall Form is used to identify, certify and invoice for all Eligible Students and Licensure Students enrolled at On-Campus and
Off-Campus sites at Approved Institutions on October 1 of the first term of the academic year to receive the NCLTG.
Authorized School Officials will complete the reverse side and have their president sign and notarize form.

An Excel spreadsheet of eligible students containing the required information must be transmitted to the NCSEAA on or before
October 20 for the first term. The Excel spreadsheet format and detailed instructions will be transmitted by the NCSEAA to the
institution at the beginning of each school term. Once the completed Excel spreadsheet is transmitted to NCSEAA by the
institution, the completed and signed J & W Fall Form should follow in the mail, as soon as possible.
NCLTG funds cannot be released until all completed documentation from all schools has been verified.
Terms Eligible Students, Licensure Students and Approved Institution defined in Rules Governing NCLTG (amended July 25, 2006).

A sample of the Excel spreadsheet is provided below:
      A            B            C         D             E                   F                G          H                      I       J
Institution   F_Name       MI        L_Name       SSN              Street_Address1                 City
                                                                                       Street_Address2                   State     Zip
Practice U    Sarah        V         Smith        159-85-2357      1245 Smithfield Rd.             Selma                 NC        27563
Practice U    George       N         Jones        135-79-8642      1485 Gordon Avenue              Zebulon               NC        27609
Practice U    Debbue       V         Doe          246-81-3579      1952 Chico Court                Raleigh               NC        27609
Practice U    Johnny                 Quest        777-77-7777      Highway 64, Box 98              Wendell               NC        28116
Practice U    Janice                 Joplin       111-11-1111      234 Main Street     Apt 3       Charlotte             NC        28999
Text(50)      Text (15)    Text(1)   Text(20)     Text(15)         Text(50)            Text(50)    Text(50)              Text(2)   Text(50)
                                                                   No P O Box #'s
     K             L        M          N            O                  P                        Q           R         S                T      U
Sex           Race                            Winter_CreditHrs pring_CreditHrs
                         Off_Site Fall_CreditHrs             S                              Summer_CreditHrs
                                                                                                      Year_FundedAcadTerm                     Curriculum Maj
                                                                                                                                   Academic_Classification
F             1          0        15                                                                  20XX-20XX Fall                          A
                                                                                                                                   Sophomore rt
M             1          0        12                                                                  20XX-20XX Fall               Junior     Pre-Med
F             3          1        12                                                                  20XX-20XX Fall               Senior     Criminal Justice
M             2          0        12                                                                  20XX-20XX Fall               Freshman English
F             1          0        12                                                                  20XX-20XX Fall                          Physics
                                                                                                                                   Unclassified
Text(1)       Nmbr(1)    Number(1)Number(2) Number(2)        Number(2)                      Number(2) Text(15)   Text(20)          Text(20) Text(4)
              1=Wht      Yes=1                                                                        ex. 20XX-XXex. Fall          ex. Sophomore
              2=Blk      No=0                                                                                    ex. Spr
              3=Amr Ind
              4=Asian
              5=Hispanic
              6=Other (Unknown)
   V               W         X           Y               Z                AA            AB            AC            AD          AE      AF
Comment       Comment_Explain                    SCSF_Spring_Award
                         SCSF_Fall_Award
                                    SCSF_Winter_Award           SCSF_Summer_Award NCLTG_Fall_Award             NCLTG_Spring_Award ISIR Trans #
                                                                                                 NCLTG_Winter_Award         Off_Campus Site
c                                0                                                          633
a              6/15/2006         0                                                          633
f                                0                                                          450                              Camp Lejeune
                                 0                                                          633
g                                0                                                          475
Text(4)       Text(200) Curr(5) Currency(5)Currency(5)          Currency(5)       Currency(5) Currency(5) Currency(5) Text(50) Text(4)
ex. A or a                                       (dollars only) (dollars only)
                         (dlrs only)(dollars only)                                (dollars only) (dollars only)(dollars only)
Comment Codes:
a) Grace period applies. Student moved on ______. Date Strudent moved must be indicated.
b) Student has out-of-state address because of divorce situation. Parent
     who claimed student pays NC taxes.
c) Parent's mailing address is in a border state but works and pays taxes in NC.
d) Parent has campus address because he/she is a faculty/staff member living
    on campus.
e) Parent is NC resident who has temporary assignment abroad/out-of-state.
f) Pro-rated award because student receives military tuition assistance.
g) Reduced award by 25% because student has exceeded 110% of the required completed quarter hours for degree
    completion.
h) Other: Explain _________________________________________________
                   NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                                    Post Office Box 13663, Research Triangle Park, NC 27709-3663

      NORTH CAROLINA LEGISLATIVE TUITION GRANT (NCLTG) INSTITUTIONAL CERTIFICATION & INVOICE
                                                             J & W WINTER FORM


NAME OF EDUCATIONAL INSTITUTION                                                                              ACADEMIC YEAR

READ REVERSE SIDE INSTRUCTIONS BEFORE COMPLETING THIS FORM. TRANSMIT ONE COPY OF YOUR ELECTRONIC
ROSTER OF ELIGIBLE STUDENTS TO NCSEAA AND RETAIN ONE COPY FOR YOUR FILES.
The institution listed above, which entered into a Participation Agreement with the NCSEAA, hereby submits a request for NCLTG payment on behalf
of and to the credit of the eligible students listed on our electronic roster submitted on ____________________.
                                                                                                     (mm/dd/yy)
1. This invoice is submitted as of ______________________, the tenth classroom day of the WINTER TERM.
                                                   (mm/dd/yy)
2. First classroom day of the school term for this invoice is _______________________________.
                                                                                         (mm/dd/yy)
3. Eligible students invoiced :


         Number of Continuing Eligible Students Awarded On Campus                                                                                    a.
         (Students that received an award in the fall & will in the winter)


         Number of New Eligible Students Awarded On Campus                                                                                           b.
         (Students that will receive an award in the winter term only)


         Number of Continuing Eligible Students Awarded Off Campus                                                                                   aa.
         (Students that received an award in the fall & will in the winter)


         Number of New Eligible Students Awarded Off Campus                                                                                          bb.
         (Students that will receive an award in the winter term only)


         Total Number of Eligible Students Invoiced for Winter 2007

I certify to the NCSEAA that to the best of my knowledge and belief each student, listed on our electronic roster, was enrolled at this institution
on October 1 in the case of the first academic term of the current school year or on the tenth classroom day of any other term of the current school year
as indicated above, and each student listed filed the NCLTG application with this institution, met all residency, academic classification, minimum academic
load and other eligibility requirements of the laws of N C and the regulations of the NCSEAA for receipt of the NCLTG for the current school term.

I further certify that the NCLTG amount received by this institution from the NCSEAA on behalf of and to the credit of each student
listed on our electronic roster will upon receipt be credited to the respective student's account established with the business
office at this institution pursuant to the NCSEAA regulations governing the NCLTG Program.




Typed or Printed Name of Chief Executive Officer                 Signature of Chief Executive Officer

Sworn to and subscribed before me this ______ day of __________________, 20______.




Notary Public                                      Seal or Stamp
NCSEAA NCLTG J & W Winter Form 7/06
                 NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                           Instructions for Submitting Certification and Invoice Forms and Electronic Rosters
                                        for the North Carolina Legislative Tuition Grant (NCLTG)
J & W Winter Form is used to identify, certify and invoice for all continuing and new Eligible Students enrolled at On-Campus and
Off-Campus sites at Approved Institutions as of the tenth classroom day and eligible for the NCLTG for the second term of the
academic year. Authorized School Officials will complete the reverse side and have their president sign and notarize form.

An Excel spreadsheet of eligible students containing the required information must be transmitted to the NCSEAA on or before
twenty (20) days following the Certification Date for the second term. The Excel spreadsheet format and detailed instructions will be
transmitted by the NCSEAA to the institution at the beginning of each school term. Once the completed Excel spreadsheet is
transmitted to NCSEAA by the institution, the completed and signed J & W Winter Form should follow in the mail, as soon as
possible. NCLTG funds cannot be released until all completed documentation from all schools has been verified.
Terms Eligible Students, Licensure Students and Approved Institution defined in Rules Governing NCLTG (amended July 25, 2006).

A sample of the Excel spreadsheet is provided below:
      A            B            C         D             E                   F                G          H                      I       J
Institution   F_Name       MI        L_Name       SSN              Street_Address1                 City
                                                                                       Street_Address2                   State     Zip
Practice U    Sarah        V         Smith        159-85-2357      1245 Smithfield Rd.             Selma                 NC        27563
Practice U    George       N         Jones        135-79-8642      1485 Gordon Avenue              Zebulon               NC        27609
Practice U    Debbue       V         Doe          246-81-3579      1952 Chico Court                Raleigh               NC        27609
Practice U    Johnny                 Quest        777-77-7777      Highway 64, Box 98              Wendell               NC        28116
Practice U    Janice                 Joplin       111-11-1111      234 Main Street     Apt 3       Charlotte             NC        28999
Text(50)      Text (15)    Text(1)   Text(20)     Text(15)         Text(50)            Text(50)    Text(50)              Text(2)   Text(50)
                                                                   No P O Box #'s
     K             L        M          N            O                  P                        Q           R         S                T      U
Sex           Race                            Winter_CreditHrs pring_CreditHrs
                         Off_Site Fall_CreditHrs             S                              Summer_CreditHrs
                                                                                                      Year_FundedAcadTerm                     Curriculum Maj
                                                                                                                                   Academic_Classification
F             1          0        15                     12                                           20XX-20XX Fall                          A
                                                                                                                                   Sophomore rt
M             1          0        12                     12                                           20XX-20XX Fall               Junior     Pre-Med
F             3          1        12                     15                                           20XX-20XX Fall               Senior     Criminal Justice
M             2          0        12                     13                                           20XX-20XX Fall               Freshman English
F             1          0        12                     12                                           20XX-20XX Fall                          Physics
                                                                                                                                   Unclassified
Text(1)       Nmbr(1)    Number(1)Number(2) Number(2)        Number(2)                      Number(2) Text(15)   Text(20)          Text(20) Text(4)
              1=Wht      Yes=1                                                                        ex. 20XX-XXex. Fall          ex. Sophomore
              2=Blk      No=0                                                                                    ex. Spr
              3=Amr Ind
              4=Asian
              5=Hispanic
              6=Other (Unknown)
   V               W         X           Y               Z                AA            AB            AC            AD          AE      AF
Comment       Comment_Explain                    SCSF_Spring_Award
                         SCSF_Fall_Award
                                    SCSF_Winter_Award           SCSF_Summer_Award NCLTG_Fall_Award             NCLTG_Spring_Award ISIR Trans #
                                                                                                 NCLTG_Winter_Award         Off_Campus Site
c                                0                                                          633           633
a              6/15/2006         0                                                          633           633
f                                0                                                          450           450                Camp Lejeune
                                 0                                                          633           633
g                                0                                                          475           475
Text(4)       Text(200) Curr(5) Currency(5)Currency(5)          Currency(5)       Currency(5) Currency(5) Currency(5) Text(50) Text(4)
ex. A or a                                       (dollars only) (dollars only)
                         (dlrs only)(dollars only)                                (dollars only) (dollars only)(dollars only)
Comment Codes:
a) Grace period applies. Student moved on ______. Date Strudent moved must be indicated.
b) Student has out-of-state address because of divorce situation. Parent
     who claimed student pays NC taxes.
c) Parent's mailing address is in a border state but works and pays taxes in NC.
d) Parent has campus address because he/she is a faculty/staff member living
    on campus.
e) Parent is NC resident who has temporary assignment abroad/out-of-state.
f) Pro-rated award because student receives military tuition assistance.
g) Reduced award by 25% because student has exceeded 110% of the required completed quarter hours for degree
    completion.
h) Other: Explain _________________________________________________
                   NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                                    Post Office Box 13663, Research Triangle Park, NC 27709-3663

      NORTH CAROLINA LEGISLATIVE TUITION GRANT (NCLTG) INSTITUTIONAL CERTIFICATION & INVOICE
                                                             J & W SPRING FORM


NAME OF EDUCATIONAL INSTITUTION                                                                              ACADEMIC YEAR

READ REVERSE SIDE INSTRUCTIONS BEFORE COMPLETING THIS FORM. TRANSMIT ONE COPY OF YOUR ELECTRONIC
ROSTER OF ELIGIBLE STUDENTS TO NCSEAA AND RETAIN ONE COPY FOR YOUR FILES.
The institution listed above, which entered into a Participation Agreement with the NCSEAA, hereby submits a request for NCLTG payment on behalf
of and to the credit of the eligible students listed on our electronic roster submitted on ____________________.
                                                                                                     (mm/dd/yy)
1. This invoice is submitted as of ______________________, the tenth classroom day of the SPRING TERM.
                                                   (mm/dd/yy)
2. First classroom day of the school term for this invoice is _______________________________.
                                                                                         (mm/dd/yy)
3. Eligible students invoiced :


         Number of Continuing Eligible Students Awarded On Campus                                                                                    a.
         (Students that received an award in the winter & will in the spring)


         Number of New Eligible Students Awarded On Campus                                                                                           b.
         (Students that will receive an award in the spring term only)


         Number of Continuing Eligible Students Awarded Off Campus                                                                                   aa.
         (Students that received an award in the winter & will in the spring)


         Number of New Eligible Students Awarded Off Campus                                                                                          bb.
         (Students that will receive an award in the spring term only)


         Total Number of Eligible Students Invoiced for Spring 2007

I certify to the NCSEAA that to the best of my knowledge and belief each student, listed on our electronic roster, was enrolled at this institution
on October 1 in the case of the first academic term of the current school year or on the tenth classroom day of any other term of the current school year
as indicated above, and each student listed filed the NCLTG application with this institution, met all residency, academic classification, minimum academic
load and other eligibility requirements of the laws of N C and the regulations of the NCSEAA for receipt of the NCLTG for the current school term.

I further certify that the NCLTG amount received by this institution from the NCSEAA on behalf of and to the credit of each student
listed on our electronic roster will upon receipt be credited to the respective student's account established with the business
office at this institution pursuant to the NCSEAA regulations governing the NCLTG Program.




Typed or Printed Name of Chief Executive Officer                 Signature of Chief Executive Officer

Sworn to and subscribed before me this ______ day of __________________, 20______.




Notary Public                                      Seal or Stamp
NCSEAA NCLTG J & W Spring Form 7/06
                 NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                           Instructions for Submitting Certification and Invoice Forms and Electronic Rosters
                                        for the North Carolina Legislative Tuition Grant (NCLTG)
J & W Spring Form is used to identify, certify and invoice for all continuing and new Eligible Students enrolled at On-Campus and
Off-Campus sites at Approved Institutions as of the tenth classroom day and eligible for the NCLTG for the second term of the
academic year. Authorized School Officials will complete the reverse side and have their president sign and notarize form.

An Excel spreadsheet of eligible students containing the required information must be transmitted to the NCSEAA on or before
twenty (20) days following the Certification Date for the second term. The Excel spreadsheet format and detailed instructions will be
transmitted by the NCSEAA to the institution at the beginning of each school term. Once the completed Excel spreadsheet is
transmitted to NCSEAA by the institution, the completed and signed J & W Spring Form should follow in the mail, as soon as
possible. NCLTG funds cannot be released until all completed documentation from all schools has been verified.
Terms Eligible Students, Licensure Students and Approved Institution defined in Rules Governing NCLTG (amended July 25, 2006).

A sample of the Excel spreadsheet is provided below:
      A            B            C         D             E                   F                G          H                      I       J
Institution   F_Name       MI        L_Name       SSN              Street_Address1                 City
                                                                                       Street_Address2                   State     Zip
Practice U    Sarah        V         Smith        159-85-2357      1245 Smithfield Rd.             Selma                 NC        27563
Practice U    George       N         Jones        135-79-8642      1485 Gordon Avenue              Zebulon               NC        27609
Practice U    Debbue       V         Doe          246-81-3579      1952 Chico Court                Raleigh               NC        27609
Practice U    Johnny                 Quest        777-77-7777      Highway 64, Box 98              Wendell               NC        28116
Practice U    Janice                 Joplin       111-11-1111      234 Main Street     Apt 3       Charlotte             NC        28999
Text(50)      Text (15)    Text(1)   Text(20)     Text(15)         Text(50)            Text(50)    Text(50)              Text(2)   Text(50)
                                                                   No P O Box #'s
     K             L        M          N            O                  P                          Q           R         S              T      U
Sex           Race                            Winter_CreditHrs pring_CreditHrs
                         Off_Site Fall_CreditHrs             S                                Summer_CreditHrs
                                                                                                        Year_FundedAcadTerm                   Curriculum Maj
                                                                                                                                   Academic_Classification
F             1          0        15                     12                              15             20XX-20XX Fall                        A
                                                                                                                                   Sophomore rt
M             1          0        12                     12                              13             20XX-20XX Fall             Junior     Pre-Med
F             3          1        12                     15                              20             20XX-20XX Fall             Senior     Criminal Justice
M             2          0        12                     13                              18             20XX-20XX Fall             Freshman English
F             1          0        12                     12                              16             20XX-20XX Fall                        Physics
                                                                                                                                   Unclassified
Text(1)       Nmbr(1)    Number(1)Number(2) Number(2)        Number(2)                        Number(2) Text(15)   Text(20)        Text(20) Text(4)
              1=Wht      Yes=1                                                                SCSF Only ex. 20XX-XXex. Fall        ex. Sophomore
              2=Blk      No=0                                                                                      ex. Spr
              3=Amr Ind
              4=Asian
              5=Hispanic
              6=Other (Unknown)
   V               W         X           Y               Z                AA            AB            AC            AD          AE      AF
Comment       Comment_Explain                    SCSF_Spring_Award
                         SCSF_Fall_Award
                                    SCSF_Winter_Award           SCSF_Summer_Award NCLTG_Fall_Award             NCLTG_Spring_Award ISIR Trans #
                                                                                                 NCLTG_Winter_Award         Off_Campus Site
c                                0                                                          633           633           634
a              6/15/2006         0                                                          633           633           634
f                                0                                                          450           450           450 Camp Lejeune
                                 0                                                          633           633           634
g                                0                                                          475           475           475
Text(4)       Text(200) Curr(5) Currency(5)Currency(5)          Currency(5)       Currency(5) Currency(5) Currency(5) Text(50) Text(4)
ex. A or a                                       (dollars only) (dollars only)
                         (dlrs only)(dollars only)                                (dollars only) (dollars only)(dollars only)
Comment Codes:
a) Grace period applies. Student moved on ______. Date Strudent moved must be indicated.
b) Student has out-of-state address because of divorce situation. Parent
     who claimed student pays NC taxes.
c) Parent's mailing address is in a border state but works and pays taxes in NC.
d) Parent has campus address because he/she is a faculty/staff member living
    on campus.
e) Parent is NC resident who has temporary assignment abroad/out-of-state.
f) Pro-rated award because student receives military tuition assistance.
g) Reduced award by 25% because student has exceeded 110% of the required completed quarter hours for degree
    completion.
h) Other: Explain _________________________________________________
     NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                                 Post Office Box 13663, Research Triangle Park, NC 27709-3663
     NORTH CAROLINA LEGISLATIVE TUITION GRANT (NCLTG) INSTITUTIONAL CERTIFICATION & INVOICE
                                                             SPRING FORM

NAME OF EDUCATIONAL INSTITUTION                                                                              ACADEMIC YEAR

READ REVERSE SIDE INSTRUCTIONS BEFORE COMPLETING THIS FORM. TRANSMIT ONE COPY OF YOUR ELECTRONIC
ROSTER OF ELIGIBLE STUDENTS TO NCSEAA AND RETAIN ONE COPY FOR YOUR FILES.
The institution listed above, which entered into a Participation Agreement with the NCSEAA, hereby submits a request for NCLTG payment on behalf
of and to the credit of the eligible students listed on our electronic roster submitted on ____________________.
                                                                                                     (mm/dd/yy)
1. This invoice is submitted as of ______________________, the tenth classroom day of the SPRING TERM.
                                                   (mm/dd/yy)
2. First classroom day of the school term for this invoice is _______________________________.
                                                                                         (mm/dd/yy)
3. Eligible students invoiced :
        Number of Continuing Eligible Students Awarded On Campus                                                                                     a.
         (Students that received an award in the fall & will in the spring)
         Number of New Eligible Students Awarded On Campus                                                                                           b.
         (Students that will receive an award in the spring term only)
         Number of Continuing Eligible Students Awarded Off Campus                                                                                   aa.
         (Students that received an award in the fall & will in the spring)
         Number of New Eligible Students Awarded Off Campus                                                                                          bb.
         (Students that will receive an award in the spring term only)
         Number of Continuing Teacher Licensure Students Awarded On Campus                                                                           c.
         (Students that received an award in the fall & will in the spring)
         Number of New Teacher Licensure Students Awarded On Campus                                                                                  d.
         (Students that will receive an award in the spring term only)
         Number of Continuing Teacher Licensure Students Awarded Off Campus                                                                          cc.
         (Students that received an award in the fall & will in the spring)
         Number of New Teacher Licensure Students Awarded Off Campus                                                                                 dd.
         (Students that will receive an award in the spring term only)
         Number of Continuing Nurse Licensure Students Awarded On Campus                                                                             e.
         (Students that received an award in the fall & will in the spring)
         Number of New Nurse Licensure Students Awarded On Campus                                                                                    f.
         (Students that will receive an award in the spring term only)
         Number of Continuing Nurse Licensure Students Awarded Off Campus                                                                            ee.
         (Students that received an award in the fall & will in the spring)
         Number of New Nurse Licensure Students Awarded Off Campus                                                                                   ff.
         (Students that will receive an award in the spring term only)

         Total Number of Eligible Students Invoiced for Spring 2007

I certify to the NCSEAA that to the best of my knowledge and belief each student, listed on our electronic roster, was enrolled at this institution
on October 1 in the case of the first academic term of the current school year or on the tenth classroom day of any other term of the current school year
as indicated above, and each student listed filed the NCLTG application with this institution, met all residency, academic classification, minimum academic
load and other eligibility requirements of the laws of N C and the regulations of the NCSEAA for receipt of the NCLTG for the current school term.

I further certify that the NCLTG amount received by this institution from the NCSEAA on behalf of and to the credit of each student
listed on our electronic roster will upon receipt be credited to the respective student's account established with the business
office at this institution pursuant to the NCSEAA regulations governing the NCLTG Program.




Typed or Printed Name of Chief Executive Officer                 Signature of Chief Executive Officer

Sworn to and subscribed before me this ______ day of __________________, 20______.


Notary Public                                      Seal or Stamp
NCSEAA NCLTG Spring Form 7/06
                          NORTH CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY (NCSEAA)
                              Instructions for Submitting Certification and Invoice Forms and Electronic Rosters
                                           for the North Carolina Legislative Tuition Grant (NCLTG)
Spring Form 7/06 is used to identify, certify and invoice for all continuing and new Eligible Students and Licensure Students
enrolled at On-Campus and Off-Campus sites at Approved Institutions as of the tenth classroom day and eligible for the NCLTG
 for the second term of the academic year. Authorized School Officials will complete the reverse side and have their president
sign and notarize form.

An Excel spreadsheet of eligible students containing the required information must be transmitted to the NCSEAA on or before
twenty days following the Certification Date for the second term. The Excel spreadsheet format and detailed instructions will be
transmitted by the NCSEAA to the institution at the beginning of each school term. Once the completed Excel spreadsheet is
transmitted to NCSEAA by the institution, the completed and signed Spring Form 7/06 should follow in the mail, as soon as
possible. NCLTG funds cannot be released until all completed documentation from all schools has been verified.
Terms Eligible Students, Licensure Students, Certification Date and Approved Institution defined in Rules Governing NCLTG (amended July 25, 2006).

A sample of the Excel spreadsheet is provided below:
       A           B             C          D               E                   F                G           H                      I           J
Institution   F_Name        MI         L_Name         SSN              Street_Address1                  City
                                                                                           Street_Address2                    State         Zip
Practice U    Sarah         V          Smith          159-85-2357      1245 Smithfield Rd.              Selma                 NC            27563
Practice U    George        N          Jones          135-79-8642      1485 Gordon Avenue               Zebulon               NC            27609
Practice U    Debbue        V          Doe            246-81-3579      1952 Chico Court                 Raleigh               NC            27609
Practice U    Johnny                   Teacher        777-77-7777      Highway 64, Box 98               Wendell               NC            28116
Practice U    Janice                   Nurse          111-11-1111      234 Main Street     Apt 3        Charlotte             NC            28999
Text(50)      Text (15)     Text(1)    Text(20)       Text(15)         Text(50)            Text(50)     Text(50)              Text(2)       Text(50)
                                                                       No P O Box #'s
     K             L        M          N              O                 P                             Q              R        S
Sex           Race                             S               S
                         Off_Site Fall_CreditHrs pring_CreditHrs ummer_CreditHours              Year_Funded     AcadTerm      Academic_Classification
F             1          0        15                       21                                   20XX-20XX       Spring        Sophomore
M             1          0        12                       16                                   20XX-20XX       Spring        Junior
F             3          1        12                       15                                   20XX-20XX       Spring        Senior
M             2          0        6                          9                                  20XX-20XX       Spring        Graduate
F             1          0        6                          4                                  20XX-20XX       Spring        Graduate
Text(1)       Nmbr(1)    Number(1)Number(2) Number(2)          Number(2)                        Text(15)        Text(20)      Text(20)
              1=Wht      Yes=1                                 SCSF Only                        ex. 20XX-XX     ex. Fall      ex. Sophomore
              2=Blk      No=0                                                                                   ex. Spr
              3=Amr Ind
              4=Asian
              5=Hispanic
              6=Other (Unknown)
      T            U           V           W               X                 Y             Z            AA           AB        AC
              Comment
Curriculum Major                     SCSF_Fall_Award
                            Comment_Explain                        SCSF_Summer_AwardNCLTG_Fall_Award
                                                   SCSF_Spring_Award                                             Off_Campus Site
                                                                                                   NCLTG_Spring_Award ISIR Trans #
Art           c                              1500                0                0           950           950
Pre-Med       a             #######            500               0                0           950           950
              f
Criminal Justice                                 0               0                0           450           450 Camp Lejeune
English       t                              1100                0                0           475           713
Physics       n                              1100                0                0           475           238
Text(4)       Text(4)       Text(200)Curr(5)       Currency(5)     Currency(5)      Currency(5) Currency(5) Text(50)       Text(4)
ex. Art       ex. A or a             (dlrs only)   (dollars only) (dollars only)    (dollars only) (dollars only)
              Comment Codes:
              a) Grace period applies. Student moved on ______. Date Student moved must be indicated.
              b) Student has out-of-state address because of divorce situation. Parent
                   who claimed student pays NC taxes.
              c) Parent's mailing address is in a border state but works and pays taxes in NC.
              d) Parent has campus address because he/she is a faculty/staff member living on campus
              e) Parent is NC resident who has temporary assignment abroad/out-of-state.
              f) Pro-rated award because student receives military tuition assistance.
              g) Reduced award by 25% because student has exceeded 140 completed hours.
              h) Other: Explain _________________________________________________
              n) Student is enrolled either full-time or part-time in a program intended to result in licensure in Nursing.
              t) Student is enrolled either full-time or part-time in a program intended to result in licensure in Teaching.

				
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