EmailMe Form - Federal Direct Loan Application

Student Name *

First Last

Student BHC Number 900 *

Student Local Address: *

Street Address City State / Province / Region Postal / Zip Code

Permanent/Home Address (if different from above):

Street Address City State / Province / Region Postal / Zip Code Country / Region

Student phone *

### - ### - ####

Do you/your family receive SNAP? *

Yes

No

How much assistance do you/your family receive per month (on average)?

How many family members does that assistance support?

Do you/your family receive rent subsidy or housing assistance? *

Yes

No

How much assistance do you/your family receive per month (on average)?

How many family members does that assistance support?

Will you receive a tuition waiver or tuition assistance (employer reimbursement, Partners in Job Training, etc.)? *

Yes

No

If yes, how much of your tuition will be covered?

ENROLLMENT INFORMATION

Are you enrolled at another College/University while attending BHC? *

Yes

No

Are you enrolled in second 8-week courses only? *

Yes

No

When will you complete your current program of study? *

Please provide the semester and year that you will complete your current program of study. *

Will you graduate or transfer? *

Graduate

Transfer

LOAN REQUEST

IMPORTANT NOTE – maximum subsidized loan eligibility will be processed before unsubsidized loans. Contact loans@bhc.edu with any questions, concerns, or updates.

Loan Period: *

Loan amount requested: *

Do you want to receive a Direct Loan if you are only eligible for an unsubsidized loan? *

Yes

No

If you are eligible for Work Study do you want to cancel all or a portion of your eligibility in order to process your loan request? *

Yes

No

CURRENT STUDENT LOAN AND REPAYMENT INFORMATION

If you are a first time borrower, enter zeroes below.

Log in to Federal Student Aid – what is the Total Balance of your Loans?*

Using the Federal Student Aid Loan Simulator: What is your estimated Monthly Payment under the Standard Repayment Plan?

Using the Federal Student Aid Loan Simulator: What is your estimated Total to Be Paid under the Standard Repayment Plan?*

First Time Borrowers at Black Hawk College with prior student loan debt, please list ALL colleges you attended and received federal loans. You must request official transcripts to be sent to Black Hawk College Enrollment Services:

WE RECOMMEND YOU PRINT THIS PAGE FOR YOUR RECORDS BEFORE YOU SIGN AND SUBMIT (right click and select “Print”)

By submitting this application, I certify that I am the student requesting loan funds, and all information provided on this form is true and complete to the best of my knowledge.

Enter your myBH student email *