Summer Pell Grant Request Form - HCC Central College

Phone: 713-718-8490
Fax: 713-718-8196
Financial Aid Office
Summer Pell Grant Request Form (FSUM15)
2014-2015
Student’s Name (PRINT): _____________________________________________ Phone: (______) __________________
HCC ID:___________________
Date of Birth: ____/_____/_______ Home Campus:__________________________
(9-digit number required)
(Primary location of attendance)
If you did not attended HCC during the Fall 2014 and Spring 2015 semesters, please complete the following to be
considered for Summer 2015 Pell Grant Eligibility. HCC must verify that you have not exhausted eligibility at another
school and you are not concurrently attending another school. HCC does not process student loans for summer.
Summer 2015 Pell Eligibility Requirements
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Summer aid applicants must complete the 2014-15 FAFSA at www.fafsa.gov.
Aid recipients must meet Satisfactory Academic Progress. Details can be found at http://www.hccs.edu/.
Applicants must declare a major in an eligible program of study which leads to a degree or certificate at HCC.
Students cannot receive financial aid at HCC and another college for the same semester or term.
Student must complete all required forms and documentation.
Academic Plans and Goals
(Do not leave any question unanswered or this form will not be processed)
Are you currently enrolled in high school (have not graduated)?
Yes
No
If YES, when will you officially graduate? ___________________
Have you earned a bachelor’s degree at another college?
Yes
No
Do you plan to graduate from HCC with a degree or certificate?
Yes
No
If YES, what is your expected graduation date? ______________
Are you attending HCC for the Summer 2015 semester only?
Yes
No
Have you enrolled or plan to enroll for the Fall 2015 semester at HCC? Yes
No
If NO, briefly please explain why:
___________________________________________________________________________________________
___________________________________________________________________________________________
Please provide your current email address: ____________________________________________________
Certification
By signing below, I hereby certify and affirm that all information on this form is true, complete, and accurate to the best
of my knowledge. I understand that any false statements or misrepresentation will be cause for denial, reduction,
withdrawal, and/or repayment of financial aid, and may be subject to a fine or imprisonment or both under provisions of
the United States Criminal Code. I certify that I am attending Houston Community College for the purpose of attaining
a degree or certificate from HCC, and I acknowledge that I cannot receive aid for classes not required of that program.
Student Signature:___________________________________
Date:_______________
SUBMIT
HCC is committed to a workplace and educational environment free of discrimination and harassment based upon race, color, religion, age, sex, gender, national
origin, disability, status as a veteran, or sexual orientation. Discrimination or harassment questions should be directed to the Office of Institutional Equity (OIE).
Updated 04/30/2015
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