Financial Aid

Dependency Review Form 2015-2016

 

PLEASE PRINT

STUDENT SECTION

Student's name:______________________________________SS#________________

Permanent address:______________________________________________________

Email:__________________________________________________________

1a. student's marital status:________ 1b. date of marital status:___________
2a. student's total earned income 2013: $________; 2014: $_______; est. 2015: $______
2b. student's total other resources 2013: $________; 2014: $_______; est. 2015: $______
3. Was student claimed by parent(s) or legal guardian in: 2013: $________; 2014: $_______; est. 2015: $______


4. Explain circumstance which justify treatment of student as self-supporting (attach other sheets as necessary):_____________________________________________________________

5. Attach documentation; describe below.

Nature of documentation:___________________________________________________

Source:__________________________________________ Date received:__________

Nature of documentation:___________________________________________________

Source:__________________________________________ Date received:__________


Student signature:_________________________________________________________

SCHOOL SECTION:6. approved:_____________ denied:_____________ date:___________

Additional information requested:__________________________________Date requested:______

Staff:_________________________________________

Mail or fax this form along with documentation of your circumstances to:


Financial Aid Office
Empire State College
111 West Ave.
Saratoga Springs, NY 12866

FAX: 518-581-2782
Phone: 518-587-2100

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financialaid@esc.edu

Fax: 518-581-2782

Mailing Address: 
Empire State College
Financial Aid
111 West Ave.
Saratoga Springs, NY 12866

Questions? Contact the Student Information Center at 518-587-2100 or 800-847-3000.

FAFSA Info

Code: 010286
Name: SUC Empire State College

TAP Codes

Undergraduate: 0913
Graduate: 5680 (for graduate students applying for Veteran Tuition Awards)

Announcements

The priority deadline to apply for financial aid for 2015-2016 is April 1, 2015.