New Student Financial Aid Information Form

STUDENT SERVICES DEPARTMENT

New Student Financial Aid Information Form - Undergraduate Student

Section A: General Information

Demographic Information

Last 4 Digits of SSN: *

Date of Birth * +

Are you 18 years of age or older? *

No

Yes

Legal Last Name *

Legal First Name *

Middle Initial

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Cell Number *

Home/Other Number

Email Address *

Enrollment Information

Campus *

Stockton

Modesto

Online

When do you plan on attending? *

Summer

Fall

Winter

Spring

Year *

What is your anticipated enrollment status? *

Full time (12 or more units)

Half time (6-8 units)

Less than half time (5 units or less)

Who is your Admission Counselor? *

What is your declared degree/major? *

Are you expecting veteran’s educational benefits? *

No

Yes

Chapter: *

Are you a current Humphreys University employee or the dependent of a Humphreys University employee who is eligible for the Humphreys University Tuition Waiver? *

No

Yes

Provide an explanation: *

Are you a current full-time employee of ABLE Charter High School or ABLE Charter Elementary? *

No

Yes

Beginning Date of Employment: *

Are you interested in being considered for federal work-study employment? *

No

Yes

What are your housing plans while attending Humphreys University? *

Your housing plan determines your cost of attendance, which is the basis for awarding financial aid (grants, scholarships, and loans).

With parent(s)/relatives: Generally, your parents/relatives are responsible for covering your housing costs. You are not required to pay rent or living expenses.

Off-campus: You are responsible for housing costs, such as rent, food, transportation, and personal expenses.

Your housing plan determines your cost of attendance, which is the basis for awarding financial aid (grants, scholarships, and loans).

With parent(s)/relatives: Generally, your parents/relatives are responsible for covering your housing costs. You are not required to pay rent or living expenses.

Off-campus: You are responsible for housing costs, such as rent, food, transportation, and personal expenses.

What is your high school completion status? *

Year *

Month *

Name of the High School & Country *

Please Explain: *

Academic History

Previous Colleges or Universities Attended:
(Beginning with the most recent, list all colleges/universities and technical/vocational schools previously attended.)

	University/College	Year Attended
1.	University/College	Year Attended
2.	University/College	Year Attended
3.	University/College	Year Attended

Do you have an Associate Degree? *

No

Yes

Major/Degree: *

Do you have a Bachelor's Degree? *

No

Yes

Major/Degree: *

Do you have a professional/Masters/Doctorate degree?

*

No

Yes

Major/Degree: *

Will you be transferring units/credits? *

No

Yes

High School Diploma	Passed HSET State Test	Passed TASC State Test	Passed CHSPE State Test	Foreign High School
GED	Other