Unusual Enrollment History 3 Institutional Evaluation Form

FA20CUE3

2020-2021

Unusual Enrollment 3

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 https://studentaid.gov to determine previous schools attended.**
**If you do not list all schools attended, your mitigating circumstances will not be approved.**

Please complete the School History Chart below.

List institutions previously attended during the four year award period (2016-2017, 2017-2018, 2018-2019, 2019-2020) where you received Pell Grant funding.


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

If you did not earn academic credit at any of the institutions listed above, please explain why.

If any transcript(s) are missing from your JCC Admissions file for any college previously attended, your financial aid application will not be processed until official transcript(s) are received.
You MUST provide a copy to the Financial Aid Office.

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.

Certifications and Signatures

By signing this form, I certify that all the information reported is complete and correct.

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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