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    Complete This Form and Submit To: UNCSA, Office of Student Financial Aid, 1533 South Main Street, Winston-Salem, NC 27127

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    Diego Vazquez-Gomez
    This document is a financial aid form for a student at the University of North Carolina School of the Arts (UNCSA). It contains two sections for the student to authorize. The first section allows the student to give permission to discuss their financial aid application and related documents with specified individuals if a password is provided. It also allows the student to not give permission to discuss this information. The second section obtains authorization for UNCSA to deduct certain expenses from the student's federal financial aid funds, such as mandatory health insurance and residence hall charges. The student can authorize or not authorize these additional expenses to be deducted.

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    Complete This Form and Submit To: UNCSA, Office of Student Financial Aid, 1533 South Main Street, Winston-Salem, NC 27127

    Uploaded by

    Diego Vazquez-Gomez
    23 views1 page
    This document is a financial aid form for a student at the University of North Carolina School of the Arts (UNCSA). It contains two sections for the student to authorize. The first section allows the student to give permission to discuss their financial aid application and related documents with specified individuals if a password is provided. It also allows the student to not give permission to discuss this information. The second section obtains authorization for UNCSA to deduct certain expenses from the student's federal financial aid funds, such as mandatory health insurance and residence hall charges. The student can authorize or not authorize these additional expenses to be deducted.

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    This document is a financial aid form for a student at the University of North Carolina School of the Arts (UNCSA). It contains two sections for the student to authorize. The first section allows the student to give permission to discuss their financial aid application and related documents with specified individuals if a password is provided. It also allows the student to not give permission to discuss this information. The second section obtains authorization for UNCSA to deduct certain expenses from the student's federal financial aid funds, such as mandatory health insurance and residence hall charges. The student can authorize or not authorize these additional expenses to be deducted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23 views1 page

    Complete This Form and Submit To: UNCSA, Office of Student Financial Aid, 1533 South Main Street, Winston-Salem, NC 27127

    Uploaded by

    Diego Vazquez-Gomez
    This document is a financial aid form for a student at the University of North Carolina School of the Arts (UNCSA). It contains two sections for the student to authorize. The first section allows the student to give permission to discuss their financial aid application and related documents with specified individuals if a password is provided. It also allows the student to not give permission to discuss this information. The second section obtains authorization for UNCSA to deduct certain expenses from the student's federal financial aid funds, such as mandatory health insurance and residence hall charges. The student can authorize or not authorize these additional expenses to be deducted.

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    NAME _______________________________________________ E-Z Arts ID________________________________

    Complete this form and submit to:


    UNCSA, Office of Student Financial Aid, 1533 South Main Street, Winston-Salem, NC 27127.
    I understand these are voluntary authorizations that will be in effect throughout my enrollment at UNCSA.
    However, I understand I may modify or rescind these authorizations with a written request at any time by submitting a new
    form to the Office of Student Financial Aid.

    Section I - Authorization to Release Confidential Information


    Due to the Family Educational Rights and Privacy Act (FERPA), the Office of Student Financial Aid cannot release information about
    a student to anyone without the student’s permission. Please indicate your preference below:
    _____ I give permission to the Office of Student Financial Aid to discuss any and all matters concerning my financial aid application
    and all related documents, awards, and payments with the person(s) listed below, if they provide the following
    password:_________________________. Please provide a single-word password. This password must be presented in order to
    receive information.
    Name Relationship to Student

    (1) ______________________________________ ______________________________________

    (2) ______________________________________ ______________________________________

    (3) ______________________________________ ______________________________________

    ____ I do not give permission to discuss my financial aid information with anyone.

    _______________________________________________ __________________
    Student signature Date

    Section II - Authorization to Pay Miscellaneous Other Charges with Financial Aid Funds
    Federal regulations require the Office of Student Financial Aid to obtain authorization before the UNCSA can deduct certain expenses
    from your federal financial aid funds. These funds include Pell Grants, FSEOG, Perkins Loans, and Direct Loans. Tuition, fees, on-
    campus room and board will be paid automatically by these proceeds, but other charges on your Student Account (such as mandatory
    health insurance, graduation fees, library replacement charges, residence hall charges, etc.) cannot be deducted without your
    authorization. Note: Parking fines and Health Services charges cannot be deducted from your financial aid and must be paid directly
    to the appropriate offices.
    In order for the Student Accounts Office to pay other charges with your Federal financial aid, you must provide permission.
    Therefore, please check one of the statements below.
    _____ I authorize the Student Accounts Office at UNCSA to deduct other charges on my Student Account (such as mandatory health
    insurance, graduation fees, library replacement charges, residence hall charges, etc.) in addition to tuition and fees, on-campus room
    and board, if applicable, from my Federal financial aid funds. I understand that this authorization must be completed before the end of the
    semester to take effect for the current semester.
    _____ I do not authorize the Student Accounts Office at UNCSA to deduct other charges on my Student Account (such as
    mandatory health insurance, graduation fees, library replacement charges, residence hall charges, etc.) in addition to tuition and fees,
    room and board, if applicable, from my Federal financial aid funds. I will be responsible for and prepared to pay these charges
    separately before each term begins.

    ________________________________________________ __________________
    Student signature Date

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