The scholarship will cover tuition and fees at an eligible institution for up to 62 total credits towards an associates degree during the course of 3 years.

I agree

The scholarship does not cover the cost of books or housing. The scholarship funds may be used for mandatory fees (registration, infrastructure, approved technology, class, contact hours and credit hours).

I agree

I will attend college as a full-time student (recommended 15 credits with a minimum of 12 credits per semester). Unless an appeal for part time attendance has been approved by the Newaygo County Area Promise Zone Board.

I agree

I must continually attend all fall and winter semesters at the same eligible institution until completion of the scholarship program (attendance during the summer semesters is optional).

I agree

I will apply for federal student aid using the Free Application for Federal Student Aid (FAFSA) each year, and complete the required verification. I understand that the Promise scholarship is a last dollar award.

I agree

When completing the FAFSA, I will include parent financial information.

I agreeI disagree

If you disagree, please select which statement(s) you can say YES to. If you select “other”, please share why you are unable to provide parent financial information and follow-up with your College Adviser. You may receive a follow-up communication based on your response.

At any time since you turned age 13, were both of your parents deceased, were you in foster care, or were you a ward or dependent of the court?Are you an emancipated minor or are you in a legal guardianship as determined by a court?Are you an unaccompanied youth who is homeless or self-supporting and at risk of being homeless?Other (Please give detail below)

Other reason unable to provide parent financial information

I will comply with my college's standards for Satisfactory Academic Progress and seek support services if needed to remain a student in good standing.

I agree

For each year of eligibility, I will complete a renewal form by June 30, prior to the start of that academic year.

I agree

I understand that the Newaygo County Area Promise Zone (NCAPZ) Board will be accessing student information from my local school district for the purpose of confirming eligibility to receive the Promise Scholarship. Under conditions specified in the FERPA regulations, 34 CFR Part 99, my school district may non-consensually disclose personally identifiable information from education records in connection with the financial aid for which I have applied or received; and for the purpose of administering the Promise Scholarship student aid program.

I agree

ELECTRONIC RELEASE AND CONSENT TERMS: I understand that the Newaygo County Area Promise Zone Board (NCAPZ) and the Newaygo County Regional Educational Service Agency (NC RESA) wishes to share information about the Promise Zone program and services with potential program participants, with the community in general, and for state and national reporting. With my permission, these materials may include images of me in print media, on broadcast media, online, or on other recorded media. I hereby consent that the NCAPZ and the NC RESA, and its entities, be authorized to use my portrait, picture, photograph, name, voice and/or image on video tape, audio tape or film, or any other reproduction of me and to distribute and/or exchange copies of these to promote their programs. No compensation is offered in exchange for permission. Promise Scholarship students must comply with the partnering institution's standards for Satisfactory Academic Progress to remain eligible. This form shall also serve as a release of information for academic records from my high school and post-secondary institution and allow the Newaygo County Area Promise Zone Authority Board to gauge use, and interest, for all scholarship dollars preserved within the Newaygo County Area Promise Zone campaign funds. By completing this form, I understand that this authorization will remain effective from the date signed until the Promise Scholarship Award term expires. I understand all information will be handled confidentially in compliance with all applicable federal laws. I also understand that I may see the academic information that is to be shared, and that I may revoke the authorization at any time by written, dated communication.

I agree

AUTHORIZATION TO RELEASE EDUCATIONAL RECORDS: I hereby authorize any school that I am enrolled in that participates in the Promise Zone Scholarship, through its agents and employees, to release any of my financial aid, attendance, demographic and/or academic record information, in whole or in part, to my local Promise Zone Authority/Organization coordinator, or his/her designee, to facilitate the analysis of my scholarship eligibility and the subsequent educational and economic impact of this scholarship. As a recipient of a Promise Zone educational scholarship, that award information becomes part of my educational record. By consenting to receive any scholarship amount awarded to me, I agree to allow the release of this information in my educational record to third parties specified under the Family Educational Rights and Privacy Act (FERPA). FERPA affords certain rights to students concerning the privacy of, and access to, their education records. While this form authorizes my school, in conjunction with the local Promise Zone Authority/Organization, to release educational records to third parties, it does not obligate either entity to do so. My school reserves the right to review and respond to requests for release of my educational record on a case-by-case basis. For additional information, I can visit the U.S. Department of Education’s website at https://www2.ed.gov/policy/gen/guid/fpco/ferpa/index.html. The Promise Zone Scholarship can have several positive impacts on postsecondary enrollment, persistence, degree attainment and overall success in college. To understand these impacts, I authorize my postsecondary academic record information, in whole or in part, to be released back to my local Promise Zone Authority/Organization coordinator, or his/her designee, in adherence to FERPA for analysis to inform and improve the Promise Zone Scholarship program. I also authorize my local Promise Zone Authority/Organization to use information regarding my scholarship in promotion of the Promise Zone Scholarship. This release is authorized starting on the date of the signature on this agreement and after scholarship receipt for statistical purposes. To rescind this Authorization, I understand that I must submit written notification of rescission to my school. I will also notify my local Promise Zone Authority/Organization in writing of my decision to rescind my authorization. This rescission would result in the termination of my receipt of the scholarship. My signature (or that of my parent/guardian if I am under the age of 18) below indicates that I have read this Authorization to Release Educational Records form and that I authorize the release of educational records as described above.

I agree