Northwest State Community College/Wright State University

Northwest State Community College/Wright State University Consortium Agreement Nursing Program at Van Wert This form is to be used by nursing students who are taking courses at Wright State University while at the same time taking courses through Northwest State Community College. A separate Consortium Agreement form should be completed for each term that students are enrolled at both institutions. PART I (to be completed by the student) Name______________________________________________________

NSCC ID #N00 __________________________

Address ____________________________________________________

Phone #_________________________________

Email Address_______________________________________________

Cell #___________________________________

Wright State ID# U00 ___________________________ (if known)

S.S. #________________________________

Classes taken at Wright State University The following courses will be taken at Wright State during the _____________________ semester ____________ year: Course#________________________

Course Name_________________________________

Semester Hours_______________

Course#________________________

Course Name_________________________________

Semester Hours _______________

Course#________________________

Course Name_________________________________

Semester Hours _______________

Classes taken at Northwest State Community College The following courses will be taken at Northwest State Community College during the ________________ semester _________year: Course#________________________

Course Name_________________________________ Semester Hours _______________

Course#________________________


Course#________________________


I hereby give Northwest State Community College and Wright State University permission to share appropriate information concerning enrollment status, attendance records, grades, fees and financial aid as necessary to execute this agreement. I understand that financial aid will be credited to my student account at Northwest State Community College and will be used first for tuition and fees, with any remaining balance available for use in the Northwest State Community College bookstore. If any financial funds remain after payment of fees and /or purchase of books and supplies at Northwest State Community College, I give authorization to Northwest State Community College to cover tuition and fees at Wright State, and then to send any remaining funds directly to me. I further understand that I must pay both Northwest State Community College and Wright State University for any tuition, fees and books not covered by financial aid funds. Student Signature____________________________________________________________

Date ____________________

Send this form to: Michael Montag, Assistant Director of Financial Aid Wright State University 3640 Colonel Glenn Highway Dayton, OH 45434-0001 Page 1

937-775-5728 877-978-3243 (toll free) 937-775-5795 (fax)

Part II (to be completed by the Financial Aid Office at Wright State University) Semester _______________

Dates: Term Begins _________________

Term Ends _____________________

Semester Hours registered________ Tuition charges Fee charges Other required charges

$__________________ $__________________ $__________________

Total Charges

$__________________

By signing this agreement, we agree to notify the Financial Aid Office at Northwest State Community College of any enrollment status changes including: adding, dropping, withdrawal, or failure to attend the course(s) listed on page 1. Financial Aid Signature: __________________________________________________________ Date: _________________ Wright State University

Part III (to be completed by the Academic Dean at Northwest State Community College) The courses listed on page 1 (to be taken at Wright State University) are applicable to the student’s current degree/certificate program at Northwest State Community College, if satisfactorily completed with a grade of “C” or better. Academic Dean’s Signature: ___________________________________________________ Date: _____________________

Part IV (to be complete by the Financial Aid Office at Northwest State Community College) The Financial Aid Office at Northwest State Community College agrees to process the student’s financial aid application, and to calculate the student’s eligibility for financial aid based on Northwest State Community College’s cost of attendance, the student’s combined enrollment status, and the total amount of fees charged at both institutions. Northwest State community College will also process any refunds or repayments resulting from the student’s withdrawal from classes. This agreement is meant to comply with the consortium agreements as outlined in the Federal Student Aid Handbook.

Financial Aid Signature_____________________________________________________ Date: ______________________

Financial Aid Office Northwest State Community College Julie Curry 22600 State Route 34 Archbold, OH 43502 419-267-1333 or 419-267-1389 Fax: 419-267-5587 [email protected]

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Financial Aid Instructions for Nursing Program at Van Wert

Students Must Read and Sign Below: 1.

When completing the Free Application for Federal Student Aid (FAFSA), students should list Federal School Codes for both Northwest State Community College 008677 and Wright State University 003078. Students should file their FAFSA electronically at www.fafsa.ed.gov using their federal PIN.

2.

Financial aid will be processed by Wright State during terms when students are taking only Wright State courses. Students must notify Wright State and let them know that they will not be enrolled at Northwest State Community College so financial aid will be processed on a timely basis.

3.

Financial aid will be processed by Northwest State Community College when students are taking courses concurrently at both schools. Student(s) must be registered for at least one course at Northwest State in order to meet this requirement. Students will need to complete the consortium agreement to include courses from both institutions. Consortium agreements are available online at Northwest State’s web site www.northweststate.edu and must be completed 6 weeks prior to the start of classes.

4.

Students are responsible for making sure that payment of tuition, fees and books is made to each school according to their respective payment deadlines. If financial aid is not process 6 weeks prior to the start of classes, the student may need to pay for courses, and get reimbursed with financial aid at a later date. Books at Wright State are paid for by the student.

5.

Northwest State Community College will add together the credit hours taken at both schools to determine Pell Grant, Federal Supplement Opportunity Grant and /or Federal Student Loan eligibility.

6.

Students must complete the FAFSA each academic year. The new FAFSA year starts with summer enrollment.

7.

Students who withdraw or stop attending all classes prior to the 60% point of the semester and who are receiving federal financial aid including grants and loans will be required to repay all unearned financial aid. This will result in owing money to the college.

8.

It is the student’s responsibility to provide Northwest State Community College with an official academic transcript of completed Wright State courses. This is to ensure that courses will properly apply to the Northwest State Community College degree.

9.

Student(s) receiving financial aid from Northwest State must comply with Northwest’s Financial Aid Satisfactory Academic Progress (SAP) Policy. This policy can be found on www.northweststate.edu.

10. Student(s) are required to send an official transcript to Northwest State Community College’s Financial Aid Office at the conclusion of each term that she/he was enrolled at Wright State University and had processed a consortium agreement. Failure to send official transcripts will delay or cancel aid for future terms. 11. I agree to authorize Wright State University to release any enrollment, academic, and tuition related information to Northwest State Community College for the contracted award year. I understand the above policy regarding my consortium agreement with Wright State University.

Student Signature: ____________________________________________________________________Date: ________________

Financial aid questions should be directed to: Wright State University Michael Montag Assistant Director of Financial Aid 3640 Colonel Glenn Highway Dayton, OH 45435-0001 [email protected] 937-775-5795 (fax)

Northwest State Community College Financial Aid Office – Julie Curry 22600 State Route 34 Archbold, OH 43502-9542 [email protected] 419-267-1333 or 419-267-1389 419-267-5587 (fax) Page 3