Application for the Scholarship for Disadvantaged Students (SDS)

Application for the Scholarship for Disadvantaged Students (SDS)

Primary Care Loan (PCL) Application

Priority deadline to apply – Friday, January 15, 2016

BACKGROUND:

The Primary Care Loan (PCL) is a program funded by the Department of Health & Human Services (HHS). Only students pursuing a M.D. are eligible to apply. Funding is only available for 3rd and 4th year students.

The Primary Care Loan program is a low cost federal loan program for medical students committed to primary health care practice. The 5% interest rate begins to accrue following a one year grace period after you cease to be a full-time student. When compared to other federal student loans and private loans, the PCL provides significant savings. The loan also offers deferment of principal and interest not found in other loan programs.

This program is separate from the Kansas Medical Student Loan. There is no requirement to practice in Kansas but there is a service requirement with this loan. Specifically:

 You must enter a residency training program in family medicine, internal medicine, pediatrics, combined medicine/pediatrics, preventive medicine or osteopathic general practice.

 PCL borrowers are to enter and complete residency training in primary health care and practice in primary health care for either 10 years (including the years spent in residency training) or through the date on which the loan is repaid in full, whichever occurs first.

For more information about this loan program, deferment options, and examples of acceptable primary health care residencies, please visit http://www.hrsa.gov/loanscholarships/loans/primarycare.html.

Interest penalties (7% interest) exist for non-compliance with the service requirement so do not indicate your willingness if you are not fully committed to primary care medicine.

Once your eligibility has been determined, you will be contacted by our office of your award or denial. Upon acceptance of a PCL award, you will be notified to complete a Rights and Responsibilities Questionnaire and Promissory Note.

IMPORTANT NOTES TO QUALIFY FOR PRIMARY CARE LOAN:

 Incomplete applications will not be considered. Please attach all necessary paperwork by the priority deadline date January 15, 2016.

 The student must be a United States citizen or eligible non-citizen

 Male students must register with Selective Service

 Owe no federal grant refund

 The student may not be in default on a federal loan

 Awards will vary each year based on funding

 Student must have financial need as determined by the Free Application for Federal Student Aid (FAFSA).

 Student must be in good academic standing and have a cumulative GPA of 2.00 in order to qualify.

______

Student Name (please print) KU ID

To be considered for the PCL, students are required to use the IRS Data Retrieval Tool (DRT) on the 2015-2016 FAFSA. Students who did not use the IRS DRT on their original FAFSA will need to log back into their 2015-2016 FAFSA and upload the information. Listed below are instructions on how to complete the process. If you are unable to use this process please contact our office.

  • Log in to your FAFSA at: www.fafsa.gov
  • Select make FAFSA Corrections
  • Enter your FSAID. (You can generate a FSAID at fsaid.ed.gov, if you don’t have one.)
  • Navigate to the "financial information section"
  • Select "already completed my tax return"
  • Select option to link to the IRS and follow the directions
  • Complete these steps for student and parent(s), if applicable
  • Click "transfer now" once your IRS data appears
  • Do not change the IRS data after it has been transferred to your FAFSA
  • Return to the FAFSA, sign and re-submit your FAFSA

If you did not file taxes in 2014, you must submit a Student Non-Filer Worksheet which is available on the Student Financial Aid Office website.

Please use this information below to determine if you will also need to submit your parent(s)’ information. Select the option(s) below that best describes your situation and attach the appropriate documentation:

If you were not 24 years old as of June 1, 2015 and/or your parent(s) claimed you as a dependent on their taxes in ANY of the last three years (2012-2014), please:

  • Complete the parent section of your 2015-16 FAFSA online (www.fafsa.gov). This information must be submitted online by December 31, 2015 to be considered for the award.
  • Parents should use the IRS Data Retrieval Tool (DRT) described earlier in this application when completing the FAFSA.

If you were the age of 24 as of June 1, 2015, AND you were NOT claimed as a dependent on your parent(s)’ tax returns in ANY of the last three years (2012-2014), please:

  • Submit proof of your age; i.e. driver’s license, passport, birth certificate or other official document(s) showing your birth date
  • Attach copies of either your, or your parent(s), 2012, 2013, and 2014 Federal Income Tax Return Transcripts (Please note, we only need one tax transcript per year, which can be either your, or your parent(s)’, for that year. For example, you could submit your parent(s)’ 2012 tax transcript along with your 2013 tax transcript, and that would suffice – any combination is fine.) You may access a copy of your IRS Federal Tax Return Transcript at: http://www.irs.gov/Individuals/Order-a-Transcript

If both of your parents are deceased:

  • Please attach a copy of the death certificates, obituaries or a third party statement.

If your parent(s) live or work in another country:

  • Please attach the equivalent to a federal tax return from the parent(s)’ country for the calendar year 2014, along with documentation of the conversion method used to convert parent(s)’ currency into U.S. dollars.
  • If your parent(s) live in another country, but are not working, please submit documentation from a disinterested third-party confirming your parent(s)’ income. Also provide documentation of the method used to convert parent(s)’ currency into US dollars.

If your parents did not file taxes in 2014 and parental information is required, you must submit a Parent Non-Filer Worksheet – available on the Student Financial Aid Office website.

SIGNATURE:

I certify that all the information reported on it is complete and correct.

______

Student SignatureDate

Please return this form and all necessary paperwork by Friday, January 15, 2016 to:

Student Financial Aid OfficeContact us:

KU Medical Centerwww.kumc.edu/studentcenter/financialaid.html

3901 Rainbow Blvd.Phone (913) 588-5170

Mail Stop 4005Fax (913) 588-8841

Kansas City, KS 66160G035 Dykes Library

PCL Application Page 1 of 2

Top View