(InternalOfficeNote:LEJA‐EinRRAAREQwhenthisformisgiven/senttothestudent.)Summer2020

LoanEducation,Justification,Application
Policy Effective 6-24-13
YOUMUSTBEENROLLEDFORAMINIMUMOF6HOURSPERTERMTOBECONSIDEREDFORALOAN.
Please print in ink.
N
ame: _____________________________________________________ Student ID # ____________________________
Address: ______________________________________ City: ___________________ State: ______ Zip: _________
New River E-mail Address: _______________________ Home Phone: ______________ Cell Phone: ________________
1. Statement of Educational Purpose: I certify that I ___________________________________ am the individual signing
(Student’s Name)
this Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for
educational purposes and to pay the cost of attending New River Community and Technical College for Summer 2020.
Please list the estimated amounts for the loan you are requesting:
Total Amount Requested: ____________
(Base amt. on entire year when applicable.)
2. Please list 2 contacts. This must be someone that does not live in your household, but has regular contact with you.
Name: _____________________________________________________ Relationship: ____________________________
Address: ______________________________________ City: ___________________ State: ______ Zip: __________
Home Phone: __________________________ Cell Phone: _____________________ Work Phone: ________________
Name: _____________________________________________________ Relationship: ____________________________
Address: ______________________________________ City: ___________________ State: ______ Zip: __________
Home Phone: __________________________ Cell Phone: _____________________ Work Phone: ________________
3. Under Federal Financial Aid guidelines all first time borrowers are required to complete entrance counseling.
Under Federal Financial Aid guidelines any student that has loans is required to complete exit counseling upon deciding to no
longer attend school, or graduation. Entrance and Exit Counseling are completed online at www.studentaid.gov.
Please initial here to acknowledge that you understand the Federal Financial Aid guidelines for Entrance and Exit
Counseling. __________
4.Due to FERPA (privacy) guidelines, Financial Aid can only respond with specific financial aid account information and/or
download documents to print when sent from your newriver.edu email account.
Please initial here to acknowledge that you understand the FERPA e‐mail guideline and that you give your permission
to use your New River email for electronic NRCTC communication. ________
Summer 1 Summer 2
Tuition and Fees
Books
Transportation
Other (please list purpose and
amount):
19-20
Borrower
The Consequences of Student Loan Default
Student Borrower Certifications and Signature
ThestudentsigningbelowcertifiesthatyouhavereadandunderstandtheConsequencesofStudentLoanDefaultandthat
alloftheinformationreportediscompleteandcorrect.
_____________________________________________________
Student’sSignature Date
PleaseuseyourNewRiveremailtosubmitthecompletedformto
finaid@newriver.edu.
Financial Aid Office Use Only!
FA Counselor FA Manager





(03-26-20)
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to
j
ail
,
or both.
Credit report damage (7 year minimum)
Wage garnishment
Seizure of federal & state tax refunds
Seizure of portion of any federal payment
Legal action in federal district court
No Federal Financial Aid (Title IV ineligible)
May lose state occupational license
No mortgage loans
May have difficulty obtaining car loans
May be unable to rent an apartment
May be turned down for jobs
Collection costs
Circle one: Offering of the loan APPROVED / DENIED
Notes:________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________

Loan Amt. Offered:
Summer1 Summer2
SUBLOAN
UNSUBLOAN
____________________________ _______
LoanAuthorizingFAAdministratorSignatureDate
FACounselorLEJA–UinRRAAREQwhenformreceived&
completeSATPROsection.
Inst.Attempted_____Inst.Passed________
%_________Inst.CumulativeGPA________
#HoursEnrolled:_______ 
SATPRO
LoanOffered
Date & time for Loan Ed. Counseling
(COUEDU–RinRRAAREQ)
__________________ _________
DateTime
DateLoanEd.CounselingComplete:
COUEDU–SRRAAREQ
Loanacceptanceformcomplete:LOAN–SRRAAREQ,ACPTloan
RPAAWRD.)
_________________ ___________
CounselorInitialDate
LoanDenied
‐NotificationsentviaNRemail
_________________ ___________
CounselorInitialDate
click to sign
signature
click to edit