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.

Please check the boxes below that apply to you:

Yes, I attended and received Pell Grant at Johnston Community College for the year 2016-2017
Yes, I attended and received Pell Grant at Johnston Community College for the year 2017-2018
Yes, I attended and received Pell Grant at Johnston Community College for the year 2018-2019
Yes, I attended and received Pell Grant at Johnston Community College for the year 2019-2020
No, I did not attend or receive Pell Grant at Johnston Community College for the year 2016-2017
No, I did not attend or receive Pell Grant at Johnston Community College for the year 2017-2018
No, I did not attend or receive Pell Grant at Johnston Community College for the year 2018-2019
No, I did not attend or receive Pell Grant at Johnston Community College for the year 2019-2020

If you answered yes to any of the above, please select the correct box below:

  • Yes, I earned academic credit while attending Johnston Community College
  • No, I did not earn any academic credit while attending Johnston Community College

WARNING:

If you purposely give false or misleading information, you may be fined, sent to prison, or both.
Student Signature
Student ID Number
Date
By checking this box, I ratify the use of my typed name and Student ID number as an electronic representation of my signature
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