Please complete this Confidential Pre-screen Form.
The information provided herein is considered highly confidential and shall not be released to any party without the express consent of the person providing the information. In order to determine the best possible solutions to your financial aid inquires, please fill out the form completely.
Student's First Name *
Student's Last Name *
Middle Initial
Student's Date of Birth *
Student's Gender Male Female
Older Parent's Date of Birth *
Street Address *
Address 2
City *
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusettes Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming *
Zip Code *
Country *
Work Phone *
Home Phone *
Fax
Email *
Cash/Checking *
Passbook Savings *
CDs *
T-Bills *
Money Market Accounts *
Stocks *
Bonds *
Tax Exempt Bonds *
Annuities *
Trust Funds *
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Just a few more questions to help us determine the best avenues for financial aid, grants and loans. Thank you.
Cd *
Money Market Accounts
Father's Income *
Mother's Income *
Student's Income *
Number In Household *
Number In College *
Enter Code
Thank you for your inquiry, we will get back to you shortly.
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