Common use of Student Information Clause in Contracts

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit hours to be taken at NSCC Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  I will transfer credits taken at Host Institution to NSCC within 14 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  Will not award any financial aid to the student in this agreement.  Will provide NSCC with documentation of the student’s enrollment at your school.  Will notify NSCC if the student fails to enroll or withdraws from the host school.  This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit hours to be taken at NSCC Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  ✓ I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  ✓ I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  ✓ I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  ✓ I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  ✓ I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  ✓ I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  ✓ I will transfer credits taken at Host Institution to NSCC within 14 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx Northwest State Community College • 00000 Xxxxx Xxxxx 00 22600 State Route 34 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  • Will not award any financial aid to the student in this agreement.  • Will provide NSCC with documentation of the student’s enrollment at your school.  • Will notify NSCC if the student fails to enroll or withdraws from the host school.  • This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number ID# Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit Number of credit hours to be taken at NSCC Number of credit hours to be taken at Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  ✓ I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  ✓ I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  ✓ I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  ✓ I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  ✓ I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  ✓ I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  ✓ I will transfer credits taken at Host Institution to NSCC within 14 15 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester _ Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ $_ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  • Will not award any financial aid to the student in this agreement.  • Will provide NSCC with documentation of the student’s enrollment at your school.  • Will notify NSCC if the student fails to enroll or withdraws from the host school.  • This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number ID# Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit hours to be taken at NSCC Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  I will transfer credits taken at Host Institution to NSCC within 14 15 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  Will not award any financial aid to the student in this agreement.  Will provide NSCC with documentation of the student’s enrollment at your school.  Will notify NSCC if the student fails to enroll or withdraws from the host school.  This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number ID# Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit Number of credit hours to be taken at NSCC Number of credit hours to be taken at Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  ✓ I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  ✓ I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  ✓ I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  ✓ I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  ✓ I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  ✓ I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  ✓ I will transfer credits taken at Host Institution to NSCC within 14 15 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  • Will not award any financial aid to the student in this agreement.  • Will provide NSCC with documentation of the student’s enrollment at your school.  • Will notify NSCC if the student fails to enroll or withdraws from the host school.  • This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit hours to be taken at NSCC Host Institution Registered Courses at Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  I will transfer credits taken at Host Institution to NSCC within 14 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: (electronic signature is not acceptable) Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  Will not award any financial aid to the student in this agreement.  Will provide NSCC with documentation of the student’s enrollment at your school.  Will notify NSCC if the student fails to enroll or withdraws from the host school.  This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Signature: (electronic signature is not acceptable) Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).

Student Information. The purpose of this consortium agreement is to enable enrolled students at NSCC to participate in financial aid programs while concurrently attending another institution (host institution) and NSCC (home institution). NSCC will be the home institution providing financial assistance. Student Name NSCC ID number Student Address City State Zip Semester and Year of Attendance Date Semester Begins Date Semester Ends Student Phone Number Student’s Major/Program Credit hours to be taken at Host Institution Credit hours to be taken at NSCC Host Institution Host Subject & Course Prefix Number Course Title/Name Credit Hours  ✓ I am asking NSCC to include my enrollment hours at my host institution for federal, state and other financial aid. I may only apply for financial aid at one institution.  ✓ I am enrolled in a degree seeking program at NSCC and agree to only enroll in courses that are transferable and/or applicable to my degree program. I understand that I am required to meet with the Department Xxxx at NSCC to confirm that all courses taken at the Host institution will transfer and are applicable to my degree program.  ✓ I understand that I will receive financial aid from NSCC and all financial aid records for this period will be maintained at the Financial Aid Office at NSCC.  ✓ I understand that financial aid will be credited to my student account at NSCC and will be used first for tuition and required fees, with any remaining balance available for use in the NSCC bookstore. Financial aid will be applied on the scheduled disbursement date of the term. The financial aid award year at NSCC begins with Summer and ends with Spring semesters.  ✓ I understand I am responsible to pay the HOST INSTITUTION for any balance owed and am subject to their payment timetable.  ✓ I will notify the Financial Aid Office at NSCC immediately of any changes in enrollment status at either institution.  ✓ I will transfer credits taken at Host Institution to NSCC within 14 days after the date the semester ends. I understand if this is not done all future financial aid at NSCC will be canceled. Student Signature: Date: Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion or age in its programs or activities. Xxxxxxxxx Xxxxx Xxxxxxxxx Xxxxxxx • 00000 Xxxxx Xxxxx 00 • Archbold • OH • 43502 Phone: 000-000-0000 • Fax 000-000-0000 • Email: xxxxxx@xxxxxxxxxxxxxx.xxx Name of Host Institution: Semester Quarter Enrollment Dates: From: To: Number of Credits Student Registered for: Total Cost Of Attendance: $ Tuition/Fees: $ Books/Supplies $ Room/Board $ Transportation $ Personal/Misc. $ Other:$  • Will not award any financial aid to the student in this agreement.  • Will provide NSCC with documentation of the student’s enrollment at your school.  • Will notify NSCC if the student fails to enroll or withdraws from the host school.  • This signed agreement acts as a release form for any academic, financial aid, transcript related, or balance related information on this student. Furthermore, your signature verifies that the student is registered for the classes listed on Part I of this agreement and all information above is accurate. Host Institution Financial Aid Signature Date Printed Name and Title Email Address Fax Number Telephone Number A consortium agreement enables the student to receive financial aid while concurrently enrolled for courses at NSCC (home institution) and another institution (host institution). Eligibility for financial assistance is based on the total credits attempted at both institutions for the semester or term provided the course work is applicable to the students major. I have reviewed the course of study and the above courses will be acceptable for transfer and will count toward the student’s degree requirements at NSCC (major or required electives).