Federal Direct PLUS Loan

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Federal Direct PLUS Loan Request Form

Student's First Name: «

Student's Middle Initial: «

Student's Last Name: «

Student's SSN: «

Student's Date of Birth: «

(mm/dd/yyyy)

Has the student submitted the 2008-09 Free Application for Federal Student Aid (FAFSA): «

Yes

Borrower's First Name: «

Borrower's Middle initial «

Borrower's Last Name: «

Borrower's SSN: «

Borrower's Date of Birth: «

(mm/dd/yyyy)

Borrower's U.S. Citizenship Status: «

Citizen/National

Eligible Noncitizen

If Eligible Noncitizen submit your Alien Registration Number:

(8 or 9 digits):

Is the Borrower in default on any loan under Federal Title IV Programs? «

Yes

Relationship to Student: «

Parent

Non-Custodial Parent

Legal Guardian

Borrower's Permanent Street Address: «

City: «

State: «

Zip: «

Telephone Number: «

Borrower's Email Address: «

If you applied for financial aid by filling the 2008-09 FAFSA and CSS PROFILE Applications, the maximum PLUS Loan amount you may borrow is displayed on the student's WebAdvisor account. Loan proceeds will be disbursed in equal installments for the fall and spring semesters.

2008-09 loan amount requested for full academic year $: «

Submission of this form authorizes the initiation of the mandatory credit review required for the Direct PLUS Loan. In addition, the Privacy Act of 1974 (5 U.S.C.552a) requires that the following notice be provided to you. The authority for collecting the information requested on this form is section 451 et.seg. of the Higher Education Act of 1965, as amended. Your disclosure of this information is voluntary. However, if you do not provide this information, you cannot be considered for a Direct PLUS Loan. The information on this form will be used to determine your eligibility for a Direct PLUS Loan.

I also agree that after all College charges collected by the Student Administrative Services Office, any excess Direct PLUS funds shall be issued to the parent borrower in the form of a check.

Because we request your Social Security Number (SSN), we must inform you that we collect your SSN on a voluntary basis, but section 484(2) of the HEA (20 U.S.C. 109(a)(4) provides that, in order to receive any grant, loan or work assistance under Title IV of the HEA, a parent must provide his or her SSN. Your SSN is used to verify your identity, and as an account number (identifier) throughout the life of your loan(s) so that data may be recorded accurately.

I have read and understand the information provided in the authorization statement: «

Yes

Date: «

Fields marked with "«" are required.