Walden - Book Loan

Book Loan Request Form

First Name:

Middle Name:

Last Name:

Home Address:

Street Address:

Apt/Ste. - Optional

City:

State:

Zip Code (ex. 00000):

Phone (ex. (111) 222-3333):

SSN (111-22-3333):

Email Address:

I have submitted my Award Acknowledgement Form:

Yes

I have completed and submitted an Entrance Interview:

Yes

I have completed my Master Promissory Note:

Yes

I have confirmed that my Official Transcripts have been received:

Yes

I have confirmed that I am currently registered for the next term:

Yes

Total Financial Aid Disbursement Amount:

Financial Aid Disbursement Date: (MM/DD/YYYY)

Book Loan Amount Requested (maximum $300)

Comments:

To verify your loan amount, visit www.getloans.com. Please allow our Office of Financial Aid 5 business days to certify your student loans once you have submitted all necessary documentation.

TERMS AND CONDITIONS

Verifiable financial aid recipients are eligible to apply.
A maximum of $300.00 can be requested.
Only one book loan will be issued per term.
The amount requested will be charged to my student account.
The University will use my financial aid disbursement to repay the amount of the book loan.
For any reason, if my financial aid disbursement is not applied to my student account, I am responsible for repaying the book loan.
Registration for future classes, transcripts, and diploma will be withheld until the balance of the book loan is repaid to my student account.
If this agreement is referred to an attorney or collection agency for collection through legal proceedings or otherwise, I agree to pay all reasonable collection costs and fees, attorneys’ fees, court costs, and other related costs to the University.
I acknowledge that I have read and agree to the terms and conditions above.

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