Student’s Name: Student ID:

Last First M.I

Permanent Mailing Address:

City State Zip Code

E-Mail Address: Date of Birth: __ Phone No:

Please use hawaii.edu e-mail address

Loan Period: FallSpring Fall/Spring Requested Loan Amount: $

Note:Anyborrowerwhohas0-29.99creditsearnedatHawaiiCommunityCollegeand/orwhohasneverreceivedaFederalStudentloanwillhavea

30-daydelayinthedisbursementoffunds.Therearetwodisbursementswithineachloanperiod.

A First-Time Borrower must:
1.Complete a loan entrancecounselingsession at Print and attach confirmation to your loan request form.
2.Electronically sign a Direct Loan MasterPromissory Note using your FSA User ID at Print and attach confirmation to your loan request form.
3.Complete the following Financial Avenue online courses @ FinancialAvenue.orgpowered by Inceptia. Print and attach confirmation to your loan request form.
□Foundations of Money(FAB1FM)
□Loan Guidance (FAB1LG)
Access code: vn4q7k
See the Financial Avenue Instructions for more information. Must pass with a score of 80% or higher.
4.Submitthisdirectloanrequestform (with attached confirmations)to the HawaiiCC Financial AidOffice. / A Second-Time Borrowermust:
  1. Complete the following Financial Avenue online courses @ FinancialAvenue.orgpowered by Inceptia. Print and attach confirmation to your loan request form.
□Spending and Borrowing (FAB2SB)
□Debt Repayment (FAB2DR)
Access code: gyecwp
See the Financial Avenue Instructions for more information. Must pass with a score of 80% or higher.
  1. Submitthisdirectloanrequestform (with attached confirmations)to the HawaiiCC Financial AidOffice.
/ A Third-Time Borrower must:
  1. Complete the following Financial Avenue online courses @ FinancialAvenue.org powered by Inceptia.Print and attach confirmation to your loan request form.
□Credit and Protecting Your Money (FAB3CM)
□Future of Your Money (FAB3FM)
Access code: js5zv3
See the Financial Avenue Instructions for more information. Must pass with a score of 80% or higher.
  1. Submitthisdirectloanrequestform (with attached confirmations)to the HawaiiCC Financial AidOffice.

By signing this application form I certify that IhavecompletedmyFAFSAapplicationandunderstand that myloanwillnotbe certifieduntilALLrequirements have been completed. I also understand that I am required to notify the Financial Aid Office of any changes in my enrollment.

Signature: ______Date: ______

Updated: January 2, 2019Hawaii CC Financial Aid Loan Request Form