Financial Aid
2016 - 2017 Additional Information Form
 
This form, along with a 2016-17 FAFSA, is used to request financial aid for Fall 2016 and Spring 2017
This form may not be used to apply for summer semester aid.
 
 
    Student Full Name:      SSN or Viterbo ID#: 
    Date You Expect to Complete Your Degree/Certificate/Licensure at Viterbo (MM/YYYY):      
 
Expected Enrollment Fall 2016 Spring 2017
Estimated Number of Credits
(Do not leave blank)
   
Undergraduate Full-time = 12 or more credits per semester (must attend at least 6 credits/semester to get aid)
Graduate Full-time = 6 or more credits per semester (must attend at least 3 credits/semester to get aid)
NOTE: Post-Baccalaureate Teacher Licensure program is considered undergraduate for financial aid purposes
starting with the 2016-17 school year
IMPORTANT: Financial aid will be awarded using the data you provide on this form and the FAFSA. It is your responsibility to notify the Financial Aid Office of changes after submitting the application. Aid can be altered for changes to credit load, course start/end dates, housing (on vs off), grade level, academic program, or external aid received. Housing, credit load, and class start/end dates will be verified at the end of the first week of each semester. You will be notified if an adjustment is made to aid due to changes in your information. Enrollment is monitored throughout the semester and adjustments made to aid as required by federal, state and university regulations.
 
Outside Assistance
1. Will you receive assistance from any of the sources listed in #2 below, as you are aware at this time?**

  a.          (If Yes, complete #2 below)  (**notify the Financial Aid Office of aid received from any external source after submitting this form)
 
2. List aid you will receive from external sources that you know at this time. Do not report aid awarded through Viterbo, including athletic, merit, or talent awards, federal/state grants, federal student loans, or work study.
Source of Outside Assistance Fall 2016
Semester Amount
Spring 2017
Semester Amount
Employer Assistance/Reimbursement
Veteran Benefit
Chapter # and Type:
Private Scholarship
Source:
Private Scholarship
Source:
Private Scholarship
Source:
Support from non-custodial parent (the parent not required to provide their information on the FAFSA)
Other (specify):
 
Colleges Attended [include any prior or current attendance at Viterbo]
College/University Name City, State Date of Attendance (MM/YYYY- MM/YYYY)
 
Scholarship Questionnaire (optional, but must be completed to be considered for donor-based scholarships)
Religious Affiliation: City/County/State of High School:
Race:              Will you be on an athletic squad in 16-17?        
Gender:          What sport(s)?  
Does your family live on and operate a farm?   Select Military Information if applicable:  
Date of High School Graduation (MM/YYYY):   Declared Minors:  
Campus/Community Involvement While Enrolled at Viterbo – include name of agency/club/organization, dates of service, and any leadership positions.
 
Student Certification and Signature
  • I understand it is my responsibility to notify the Financial Aid Office of changes to the information provided on this form or other supporting documents. Changes include, but are not limited to, increasing or decreasing credit load, changing academic program (major), changing housing status (on, off, with parent), and/or receipt of assistance from an outside source (scholarship, employer reimbursement, etc.).
  • I agree it is my obligation to attend class regularly and make progress toward my degree requirements. Failure to attend and/or otherwise make progress toward program requirements will result in reduction and/or cancellation of financial aid and possible suspension from future assistance. A copy of the Viterbo “Standards of Satisfactory Academic Progress for Financial Aid” is available on the Financial Aid homepage or in paper form from the Financial Aid Office upon request.
  • I agree to keep Viterbo University informed of my current address and phone number so I can be contacted as needed.
  • I understand that Viterbo University may share information from my financial aid records with relevant agencies or institutions that provide educational assistance.
  • It is my responsibility to know the consequences of dropping, withdrawing, or failing a course(s).
 
My signature (actual or electronic) affirms that all information reported on this form is true and complete at the time of submission. My signature further declares my understanding of the certification statements listed above. I agree that my electronic signature is the legal equivalent of my hand-written signature.
  Student Signature:           Signature Date: