Study away cost verification form
Wheaton College
This form serves as a Consortium Agreement so that you may use some or your entire financial aid award for an approved JYA program. [Please Note: This form does not apply if you are attending any of the following programs: PRESCHO (CORDOBA, SPAIN), any of the Boston University programs, the Development Study Center in Rehovet, Israel, or the American Collegiate Consortium in the former Soviet Union.] As your home institution, Wheaton can transfer a portion of your financial aid to anther school program as long as the Academic Advising Office has approved the program in advance and you have been granted official JYA status. In addition you must have completed all necessary documentation in the Office of Student Financial Services. Official JYA status means that Wheaton will consider you to be a fully registered student. This agreement specifies that only one institution, the "home institution," may award you federal or state financial aid. You may receive financial assistance from the host school or program as long as the funding is not from the federal or state government. As with any outside awards, you are required to notify the Office of Student Financial Services if you do receive any assistance directly from your host institution.
Please complete the front part of this form and then forward it to your JYA host institution. A representative of that institution should complete the reverse side and return the completed form to the Office of Student Financial Services. We cannot continue processing any financial aid award for you until we have received this completed form. If you are attending two different JYA programs, you must complete one of these forms for each program.
Your eligibility for aid while on a JYA program is based in part upon the overall cost of your program as certified on this form by your host institution. While attending a JYA program your work-study award will be canceled. You and/or your family must make up for the absence of the work-study portion of your aid award, since work-study cannot be used away from Wheaton.
Any financial aid you receive from Wheaton will be applied to your student account. Once you have received a bill from your host institution, you must present it to the Office of Student Financial Services who will arrange for the funds to be transferred. Funds cannot actually be transferred until they are received by the College, i.e., the Federal Stafford Loan check has been received and endorsed., Federal Perkins Loan promissory note signed, Federal Pell Grant processed, state scholarship certified and paid to Wheaton, etc. It is your responsibility to ensure that the necessary paperwork as been completed in the Office of Student Financial Services
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TO BE COMPLETED BY STUDENT
1. Student Name_____________________________ SS#______________
2. Permanent Address_________________________ Tel.#_____________
3. I will be attending the following JYA program:_______________________
for: A. 2000-2001 academic year _____
B. 2000 Fall semester only _____
C. 2001 Spring semester only _____
4. Have you applied or will you be applying for financial assistance from any source other than Wheaton?
Yes [ ] No [ ]
If yes, please list source(s) and amount if known ____________________
5. I certify that the above information is true and complete and that I will notify the Wheaton College Office of Student Financial Services of any changes.
Student Signature_____________________________ Date_______________
TO BE COMPLETED BY THE JYA HOST INSTITUTION
1. Name of Program: __________________________________________
2. Program Address: __________________________________________
3. Contact Person: ____________________ Title: __________________
4. Telephone Number: (_____)____________ Fax Number: (____)____________
5. Length of Program: In weeks ___________ # of Terms: __________________
Starting Date: _______________________ Ending Date: __________________
6. Enrollment Status: Less-than-half-time [ ] Half Time [ ] Three-quarter-time [ ] Full Time [ ]
| 7. Estimated Costs: Tuition | ____________________ |
| Mandatory Fees | ____________________ |
| Room & Board | ____________________ |
| Books & Supplies | ____________________ |
| Travel | ____________________ |
| Other | ____________________ |
| TOTAL | ____________________ |
8. Has this student submitted an application for financial assistance from your program? Yes [ ] No [ ]
If yes, what is the status of this applicant? _____________________________
Has any assistance been awarded to this student? Yes [ ] No [ ]
If yes, describe and give amounts _____________________________________
CERTIFICATIONS
A. The Host Institution certifies that the student has been accepted for the program listed above in #1.
B. The Host Institution agrees that only Wheaton College will award or disburse any federal or state financial aid to the student, including the Federal Pell Grant. Further, the Host Institution agrees to notify the Wheaton College Office of Student Financial Services if it offers any financial assistance to the student for the enrollment period listed above.
C. Wheaton College agrees that it will maintain all records related to the studentís financial aid.
D. The Host Institution agrees to notify the Wheaton College Office of Student Financial Services if the student changes his or her enrollment status or withdraws from the program before its completion or if any of the charges listed above in #7 changes during the period of enrollment. An academic transcript upon written request of the student will evidence satisfactory completion of the program.
E. Should the student be eligible for any financial assistance from Wheaton College, Wheaton College agrees to provide payment to the Host Institution, provided that the student has completed his or her application and all other necessary paperwork and the funds have been received by Wheaton College.
| FOR WHEATON COLLEGE | FOR JYA HOST INSTITUTION |
| _____________________________ | ______________________________ |
| Signature | Signature |
| _____________________________ | ______________________________ |
| Name & Title (please print) | Name & Title (please print) |
| _____________________________ | ______________________________ |
| Date | Date |
PLEASE RETURN TO: Office of Student Financial Services, Wheaton College, East Main Street, Norton, Ma 02766