Student Support Services Student Eligibility and Certification Summary Grant Year: Student Name: Social Security #: Classification: Enrolled at Institution? Yes No   Sophomore Junior Senior Completed credit hours Eligibility: First Generation College Student? Yes No   Low Income Verified Financial Aid Verified Family Size Taxable Family Income Document Received for Verification Needs survey and determination of academic need: Check if complete  Comments: The signing of this form is to certify that all documents have been reviewed and eligibility has been determined and approved by the proceeding initials and the following signature of a different staff member. SSS Member Signature Date
Student Support Services Student Eligibility and Certification Summary Grant Year: Student Name: Social Security #: Classification: Enrolled at Institution?  Yes  No Sophomore Junior Senior Completed credit hours Eligibility: First Generation College Student?  Yes  No Low Income Verified Financial Aid Verified Family Size Taxable Family Income Document Received for Verification Needs survey and determination of academic need:  Check if complete Comments: The signing of this form is to certify that all documents have been reviewed and eligibility has been determined and approved by the proceeding initials and the following signature of a different staff member. SSS Member Signature Date
ParticipantDocumentation.docx