Page 104 - Fall 2021 GCC Class Schedule

102 GCC SCHEDULE • FALL 2021

Do any of these apply to you? Q19. I have certification from the National Guard Adjutant
General that I’m eligible for a dependent’s fee waiver.
If you don’t qualify by income, see if you qualify through
a special classification. Check all that apply. Q20. I have documentation from the Department of Veterans
Affairs that I received the Congressional Medal of Honor
Q16. I currently receive monthly cash assistance for myself or or I’m the child of a recipient.
my dependents from:
TANF (Temporary Assistance for Needy Families)/ Q21. I have documentation from the CA Victim Compensation
CalWORKs and Government Claims Board that I’m a dependent of a
SSI/SSP (Supplemental Security Income/ September 11, 2001 terrorist attack victim.
State Supplemental Program)
General Assistance Q22. I have documentation from the public agency employer
of record that I’m a dependent of a deceased law
Q17. My parent(s)/RDP receive monthly cash assistance from enforcement/fire suppression personnel killed in the
TANF/CalWORKs or SSI/SSP as their sole source of income line of duty.
(if you’re a dependent).
Q23. I have documentation from the Department of Corrections
Q18. I have certification from the CA Department of Veterans and Rehabilitation that I’ve been exonerated of a crime
Affairs that I’m eligible for a dependent’s fee waiver. by writ of habeas corpus or pardon.

Signature Applicant’s Signature
Date
I certify the information provided here is true and accurate to Parent Signature (Dependent Students Only)
the best of my knowledge. Date
I will provide proof of the information I provided here if asked
by a college official.

I understand any false statement or failure to give proof when
asked may be cause for the denial, reduction, withdrawal, and/or
repayment of my enrollment fee waiver.

HOW TO SUBMIT WHAT TO EXPECT

Each community college is different. Follow the submission instructions Most fee waivers are processed within 1 week, check your college
posted below. email after submission. Remember, if awarded, you must reapply
DROP-OFF LOCATION for CCPG each academic year you are enrolled.

Financial Aid Dept, Sierra Vista Building, 3rd Floor

EMAIL FORM TO ADDRESS BELOW AS A PDF ATTACHMENT
AND AWAIT CONFIRMATION REPLY

finaid@glendale.edu

YOUR PRIVACY IS IMPORTANT TO US CONTACT

You’ve trusted us with personal information and we take that seriously. The Email:
only reason we ask is to determine your financial aid eligibility. In some cases,
we may ask for documentation about information you’ve provided here. finaid@glendale.edu
Please respond quickly to prevent delays.
Phone:
The California Community Colleges, in compliance with federal and state
laws, do not discriminate on the basis of race, religion, color, national origin, (818) 240-1000 ext. 5916
gender, age, disability, medical condition, sexual orientation, domestic
partnership, immigration status, citizenship, primary language, or any other Address:
legally protected basis. Talk to the financial aid office if you have questions
about these policies. You have the right to access any records established from Financial Aid Office
information in this form. This form’s information may be transmitted to other 1500 North Verdugo Road
state agencies and the federal government if required by law. Glendale, CA 91208

FOR OFFICE USE ONLY CCPG-B Special Classification National Guard Dependent Student is not eligible
CCPG-C Medal of Honor Veteran 9/11 Dependent Date:
CCPG-A CCPG-Homeless Dept. of deceased/disabled law enforcement or fire personnel
TANF/CalWORKs
GA Certified by:
SSI/SSP

Comments:

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