Phone: 713-718-8490 Fax: 713-718-8196 Financial Aid Office Summer Pell Grant Request Form (FSUM15) 2014-2015 Student’s Name (PRINT): _____________________________________________ Phone: (______) __________________ HCC ID:___________________ Date of Birth: ____/_____/_______ Home Campus:__________________________ (9-digit number required) (Primary location of attendance) If you did not attended HCC during the Fall 2014 and Spring 2015 semesters, please complete the following to be considered for Summer 2015 Pell Grant Eligibility. HCC must verify that you have not exhausted eligibility at another school and you are not concurrently attending another school. HCC does not process student loans for summer. Summer 2015 Pell Eligibility Requirements      Summer aid applicants must complete the 2014-15 FAFSA at www.fafsa.gov. Aid recipients must meet Satisfactory Academic Progress. Details can be found at http://www.hccs.edu/. Applicants must declare a major in an eligible program of study which leads to a degree or certificate at HCC. Students cannot receive financial aid at HCC and another college for the same semester or term. Student must complete all required forms and documentation. Academic Plans and Goals (Do not leave any question unanswered or this form will not be processed) Are you currently enrolled in high school (have not graduated)? Yes No If YES, when will you officially graduate? ___________________ Have you earned a bachelor’s degree at another college? Yes No Do you plan to graduate from HCC with a degree or certificate? Yes No If YES, what is your expected graduation date? ______________ Are you attending HCC for the Summer 2015 semester only? Yes No Have you enrolled or plan to enroll for the Fall 2015 semester at HCC? Yes No If NO, briefly please explain why: ___________________________________________________________________________________________ ___________________________________________________________________________________________ Please provide your current email address: ____________________________________________________ Certification By signing below, I hereby certify and affirm that all information on this form is true, complete, and accurate to the best of my knowledge. I understand that any false statements or misrepresentation will be cause for denial, reduction, withdrawal, and/or repayment of financial aid, and may be subject to a fine or imprisonment or both under provisions of the United States Criminal Code. I certify that I am attending Houston Community College for the purpose of attaining a degree or certificate from HCC, and I acknowledge that I cannot receive aid for classes not required of that program. Student Signature:___________________________________ Date:_______________ SUBMIT HCC is committed to a workplace and educational environment free of discrimination and harassment based upon race, color, religion, age, sex, gender, national origin, disability, status as a veteran, or sexual orientation. Discrimination or harassment questions should be directed to the Office of Institutional Equity (OIE). Updated 04/30/2015 Page 1 of 1