(Print Student's Name). Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to ...
Return completed form to: Castleton University Financial & Registration Services 62 Alumni Drive Castleton, VT 05735 Phone: (802) 468-6070 Fax: (802) 468-6097
Identity and Statement of Educational Purpose (To Be Signed With Notary)
Student Name_____________________________________________________ ID #_________________________ Date of Birth ______________________________________________________ If the student is unable to appear in person at Castleton University to verify his or her identity, the student must provide to the institution: (a) A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in the notary statement below, or that is presented to a notary, such as, but not limited to, a valid driver’s license, other state-issued ID, or passport;; and (b) The original Statement of Educational Purpose (in English or Spanish), provided below, which must be notarized. If the notary statement appears on a separate page than the Statement of Educational Purpose, there must be a clear indication that the Statement of Educational Purpose was the document notarized.
Statement of Educational Purpose I certify that I _______________________________________ am the individual signing this Statement of (Print Student’s Name) Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending Castleton University for 2018-2019. ____________________________________________________ _______________________________ (Student’s Signature) (Date) ____________________________________________________ (Student’s ID Number)
Declaracion de Proposito Educativo Certifico que yo, _____________________________________. soy el individuo que firma esta (Imprimir Nombre del Estudiante) Declaracion de Finalidad Educativa y que la ayuda financiera federal estudiantil que yo pueda recibir, solo sera utilizada para fines educativos y para pagar el costo de asistir a Castleton University para 2018-2019. ____________________________________________________ ________________________________ (Firma del Estudiante) (la Fecha) ____________________________________________________ (Numero de Identificacion del Estudiante) CFC18EDP
Notary’s Certificate of Acknowledgement Notary’s certification may vary by State
State of ______________________________ City/County of ___________________________________________________________________________ On___________________________, before me, _______________________________________________, (Date) (Notary’s name) personally appeared, ___________________________________________________, and proved to me on (Printed name of signer) basis of satisfactory evidence of identification __________________________________________________ (Type of unexpired, valid government-issued photo ID provided) to be the above-named person who signed the foregoing instrument. I have notarized the signing of the Statement of Educational Purpose. WITNESS my hand and official seal (seal) _______________________________________________________ (Notary signature) My commission expires on _______________________________. (Date) Note to the Notary: If the wording on this Notary Certificate of Acknowledgement is not right for the state the act will occur, please attach a certificate with the wording appropriate for the state in question. **Please attach a copy of the identification used in the acknowledgement.
