Webster-Barnes Emergency Student Loan Application

Webster-Barnes Emergency Student Loan Application
All loans will bear a 6% annual interest rate. Repayment begins 9 months after graduation. Interest does
not start accruing until 9 months after the student graduates (9 month Grace Period). If the student
transfers to another college or university, this repayment provision still applies to the same time after
graduation from such other institution.
Name:
College Major:
CSU ID:
Degree Anticipated:
Expected Graduation Date:
Cumulative GPA or Rank (if DVM):
U.S. Citizen: Yes [ ] No [ ]
Current Attendance: Full-time [ ] Part-time [ ]
Permanent Resident: Yes [ ] No [ ]
Student Status: [ ] Undergraduate [ ] Graduate [ ] DVM: 1st 2nd
3rd
4th
(Note: Graduate student must be enrolled for "1 degree seeking credit" during the semester of the loan.)
Mailing Address:
Street
Permanent Address:
City
Street
State
City
Zip
State
Zip
Best Contact Phone Number:
Email Address:
Semester Applied for: [ ] Summer [ ] Fall [ ] Spring
Amount Requested:
Student's Unmet Need:
(LOAN IS NOT TO EXCEED ONE-HALF THE TOTAL COST OF EDUCATION PER YEAR, NOR EXCEED
"UNMET NEED" AS DETERMINED BY THE OFFICE OF STUDENT FINANCIAL SERVICES, NOR EXCEED
$5,000.)
Have you applied for financial aid at CSU? [ ] Yes [ ] No
Have you received loans? [ ] Yes* [ ] No
*If Yes, please list loans received and amounts
Have you received scholarships? [ ] Yes [ ] No
*If Yes, list scholarships received and amounts
Special involvement/activities that support your application:
Provide additional information related to your circumstances or education plans as you deem
appropriate:
I,
(print your name)
, agree to abide by all of the terms and conditions of the loan
program if I am granted a loan from this fund.
Applicant’s Signature:
Date:
In the event my application is approved, I hereby authorize Colorado State University to release
information regarding my academic record to any organization or agency which has provided financial
assistance for me.
Applicant’s Signature:
Date:
Signatures Required for College Approval:
Signature of the head of the department with which the student is associated
or the
Associate Dean for Veterinary Academic and Student Affairs
Date
Signature of the DVM Financial Education Specialist
Date
Revised 03/2015