Federal Direct Loan Request Form Fall 2021/Spring 2022 Personal InformationName * Required First Middle Last Former Name Address * Required Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneAlternate PhoneSocial Security # * Required Date of Birth - must be mm/dd/yyyy format * Required MM slash DD slash YYYY Degree or Certificate Program at JC * Required Estimated JC Completion Date - must be mm/dd/yyyy format * Required MM slash DD slash YYYY Enrollment PlansFall 2021 Semester Dates: August 2021 - December 2021Attending (Min of 6 credit hours required)No Loan RequestedSpring 2022 Semester Dates: January 2022 - April 2022Attending (Min of 6 credit hours required)No Loan RequestedHave you received Federal Direct Loan funds from another college or university (other than JC) during the current 2021-2022 academic year? * Required Yes No CertificationALL BOXES MUST BE CHECKED. IF YOU HAVE QUESTIONS, PLEASE CONTACT THE JC FINANCIAL AID OFFICE BEFORE SUBMITTING THIS FORM. BY CLICKING SUBMIT BELOW, I AGREE THAT THE INFORMATION I HAVE PROVIDED ON THIS FEDERAL DIRECT LOAN REQUEST FORM IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. * Required I understand that I am requesting a loan which must be repaid. * Required I understand it is my responsibility to verify that my name and address are correct with the JC Records Office. * Required I understand that submitting a loan request does not guarantee loan processing. I understand that all required documentation must be on file before loan consideration can begin. * Required I understand that I must be enrolled in at least 6 Title IV credit hours and if I am not enrolled at least half time, any future disbursements of my loan will be cancelled. * Required I understand that the other financial aid I am receiving (including Work Study) could affect the amount of loan funding I receive. * Required I understand that if I am a first time borrower at JC, I must complete Entrance Counseling (Step 2). * Required I understand that if I am a first time borrower at JC, I must complete a new Federal Direct Loan Master Promissory Note. (Step 3). * Required I understand that if I have a loan for one semester only, my loan will be received in two separate disbursements. * Required I understand that if I am transferring to JC and requesting loan funds, I may be required to submit an unofficial copy of my previous academic transcripts to the JC Financial Aid Office.