Student Name
Student ID #
New regulations from the Department of Education requires institutions to check unusual enrollment history in an effort to prevent fraud and abuse in the Federal Pell Grant Program. Federal regulations allow the Financial Aid Office to determine whether a student should continue receiving Title IV aid to students that failed to earn credit at each previously attended institutions if they can document that there were mitigating circumstances beyond their control. Documentation must support the reasons given by the student for the student’s failure to earn academic credit and that the student did not enroll only to receive credit balance funds.

NOTE:

**You must visit www.nslds.ed.gov to determine previous schools attended.**
**If you do not list all schools attended, your mitigating circumstances will not be approved.**



Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned
Name of School Attended
Location of School
Years Attended
# of Credit Hours Earned

NOTE:

*Make sure all official transcripts from previously attended colleges have been submitted to the Admissions Office.
Your financial aid application will not be processed without all official transcripts from previously attended colleges.

WARNING:

If you purposely give false or misleading information, you may be fined, sent to prison, or both.
Student Signature
Student ID Number
Date
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