2022-2023 Confirmation of Housing for Financial Aid Form

Eligibility for need-based financial aid is based on your FAFSA and on the costs you incur while pursuing your education. Please complete and submit this form so that Student Financial Services can accurately update your financial aid based on your living situation this year.
Student Information
Name Name First Last
I know my Simmons ID number:

I know my Simmons ID number: Yes No
Simmons ID:
Must be 7 digits. Currently Entered: 0 digits.
Date of Birth: Date of Birth: / MM / DD YYYY
Email
Housing Information
For the 2022-23 academic year:

For the 2022-23 academic year: I will live with my parents/ family/ guardian I will live off campus and will be required to pay rent or a mortgage
How many roommates do you have/will share your expenses?
How much do you, personally, pay in rent/mortgage per month? $ Dollars . Cents
Off Campus Address Off Campus Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Additional Context
Is there any additional information you would like to provide?
Documentation

In order to update your financial aid, you must submit a copy of your official, signed lease or agreement that outlines the terms of payment for your housing arrangement. If you do not have an official agreement at this time, you will be required to submit this documentation prior to August 1, 2022. If we do not receive this documentation by the due date, any changes made to your financial aid based on the submission of this form will be reversed and you will be responsible for any balance this creates on your account at Simmons.
I have a signed copy of my official lease/mortgage agreement with an agency and will attach it now. I have a signed letter from a third party (ex: family member or friend) outlining the terms and conditions of our agreement AND a copy of my banking statement to document payments made thus far. I do not currently have one of the above available to attach. However I understand documentation is required and will email a signed copy to Student Financial Services ([email protected]) as soon as possible and no later than August 1, 2022.
Upload Documentation (Ex: Signed Agreement and Bank Statements)

Attach Files

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Certification and Signature

Please check the certifications below and sign.
I certify that,

I certify that, To the best of my knowledge, the information provided on this form is correct and complete. I understand that falsification of any information on this form will jeopardize my financial aid eligibility. I understand that completing this form may or may not result in changes to my financial aid. I understand that SFS may require further documentation to update my account. I understand that Simmons will use a standardized value to update my cost of attendance and financial aid. If I have exceptional circumstances that result in significantly high living costs, I should contact my financial aid officer to discuss my situation. I authorize Student Financial Services to contact my housing provider for clarification of the agreement if necessary.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Today's Date Today's Date / MM / DD YYYY

2022-2023 Confirmation of Housing for Financial Aid Form

2022-2023 Confirmation of Housing for Financial Aid Form

Student Information

Housing Information

Additional Context

Documentation

Certification and Signature