THE CANTON STUDENT LOAN FOUNDATION

Transcription

1 THE CANTON STUDENT LOAN FOUNDATION 4974 HIGBEE AVENUE NW SUITE #204 CANTON, OH PHONE: (330) FAX: (330) WEBSITE: STUDENT LOAN APPLICATION DEADLINE FOR RECEIPT OF APPLICATION IS JUNE 1, 2012 OTHER REQUIRED ITEMS (see information sheet and checklist for details): Official and final transcripts (high school and college, if applicable) ACT and/or SAT scores

2 2 letters of reference- no friends or family or neighbors Student Aid Report (SAR) from the FAFSA (or co-maker 1040 tax return) * ALL INFORMATION/SECTIONS MUST BE FULLY COMPLETED OR APPLICATION WILL NOT BE PROCESSED- DO NOT LEAVE BLANKS! USE NA IF NOT APPLICABLE. I. APPLICANT PERSONAL/FINANCIAL INFORMATION Applicant's Full Name: Permanent Address: (Street) (City) (State) (Zip) Social Security #: Date of Birth: Age: Address: Home Phone: Cell Phone: Siblings: How many? Ages: How many in College? Dependents: How many? Ages: How many in college? Present Employer/Position: Years worked: Salary: Annual Income: Does borrower own their home? No Yes What is the value? Outstanding mortgage? Financial Institution at which borrower maintains an account: Checking account #: Savings account #: Total value of borrowers assets (such as stocks, bonds, etc- please list): Total indebtedness for borrower (list creditor & amount -i.e., car loans, student loans, credit cards, etc.): II. HIGH SCHOOL INFORMATION (Note: An OFFICIAL/FINAL transcript must be submitted) High School Attended: Year Graduated: Nature of Courses Taken: College Prep Commercial Technical General List the High School activities in which you have participated (Indicate if you were an officer): What scholarships, awards, honors or prizes have you received?

3 III. COLLEGE INFORMATION (Note: An OFFICIAL/FINAL transcript (s) must be submitted) What college(s) have you attended? Years completed: College Major/Minor: What college do you plan to attend this year? College Major/Minor: What is your anticipated college graduation date? Future plans and career goals: IV. FINANCIAL INFORMATION This section must be fully completed. We realize you may not have final numbers, however, please give us your best estimate. Please be sure that YOUR ANTICIPATED EXPENSES EQUALS YOUR ANTICIPATED FUNDS (A total must equal B total). ITEMIZED ANTICIPATED EXPENSES ITEMIZED ANTICIPATED FUNDS Tuition/Fees $ Family $ Books $ CSLF Loan $ Room $ Other Loans $ Board $ Grants $ Personal Expenses $ Scholarships $ Travel $ Work Study $ Other $ Other $ = Total Expense (A) $ Total Funds (B) $ Loan Amount Eligibility as follows: Incoming Freshman-$3,000 for 4 yrs; Incoming Sophomore- $4,000 for 3 yrs; Incoming Junior-$6,000 for 2 yrs; Incoming Senior- $6,000 (Lifetime maximum loan amount: $12,000) (Loans for undergraduate work only) TOTAL REQUESTED FROM CSLF FOR ACADEMIC YEAR 12-13? $ (If A does not equal B please go back and refigure your numbers) 1 V. MISCELLANEOUS INFORMATION List the name, address, telephone number, and relationship of two relatives not living with you. Co-makers cannot be listed here and those listed cannot live at the same address. Name Address (include city, state and zip) Phone Relationship 2 Please comment on any special circumstances you would like the selection committee to consider when evaluating your loan request:

4 VI. INFORMATION REGARDING OTHER CONTRACTUALLY BOUND PARTIES Two co-makers are required. For confidential use by the Selection Committee. Co-Maker #1 Information Co-Maker #2 Information Full Name Address City, State, Zip Home Phone Cell Phone Address Relationship to Borrower U. S. Citizen No Yes No Yes Social Security Number Date of Birth Place of Birth Education Level Occupation Name of Employer Address of Employer Work Phone Number Annual Income What is the value of your home? Outstanding mortgage amt? Financial Institutions where you have accts? Checking Acct # Savings Acct # Total value of other assets such as bonds, stocks, etc(please list) OVER

5 Outstanding indebtedness. List creditor & amount (i.e., credit card, car loans, etc.) Do not include utilities or housing. How many loans have you signed as co-maker at CSLF? And for Whom? Has co-maker borrowed from CSLF? What name? Has co-maker ever been in default/ past due w/cslf? How many? Names: How many? Names: No Yes Name: No Yes Name: No Yes No Yes VII. RECIPIENT/CO-MAKER PLEDGES RECIPIENT'S PLEDGE On the basis of the information set forth in this application which I represent to be true, I respectfully request that a loan of $ be granted to me for the school year beginning 20. I agree to repay my loan with interest in accordance with the provisions contained in the Promissory Note I will sign to evidence my loan. I authorize the Canton Student Loan Foundation to obtain my consumer credit report and to investigate any information contained herein as may be necessary. I also acknowledge that fees may be incurred and reports may be made to a consumer credit bureau if this account is ever more than 90 days delinquent. I further agree to make an academic report to the Foundation at least once a year in form and substance sufficient to the Foundation s requirements and at such times as requested by the Foundation, and to keep the Foundation informed of my name, address, phone numbers, banking/financial information including institution and account numbers, and student status until my obligations are fully repaid. I further agree to notify the Foundation immediately should I withdraw from school or drop below full time status during any academic term. PLEDGE OF CO-MAKER Each of us hereby individually declares that we have read the statements made by the applicant in the application and pledge that, to the best of our knowledge and belief, they are correct. We authorize the Canton Student Loan Foundation to obtain my/our consumer credit report and to investigate any information contained herein as may be necessary. We also acknowledge that fees may be incurred and reports may be made to a consumer credit bureau if this account is ever more than 90 days delinquent. We further express our desire that a loan be granted in accordance with the policies and requirements of The Canton Student Loan Foundation and upon the conditions set forth in the application, pledge, and promissory note, and further agree to execute said note as a co-maker for the entire amount loaned; and agree that if the applicant defaults in the payment of said note, we will repay the note in accordance with it's terms without further notice or demand. We further agree to keep the Foundation informed of name, address, phone numbers, banking/financial information including institution and account numbers, and place and status of employment until this obligation is fully repaid. We agree to notify the Foundation immediately should the student recipient withdraw from school or drop below full time status during any academic term. THE OHIO LAW AGAINST DISCRIMINATION REQUIRES THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CUSTOMERS AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW. 9/15/11