STONY BROOK UNIVERSITY SCHOOL OF MEDICINE

STONY BROOK UNIVERSITY

SCHOOL OF MEDICINE

INSTITUTIONAL APPLICATION FOR FINANCIAL AID

2017-18 ACADEMIC YEAR

1. All students must file the Free Application for Federal Student Aid (FAFSA) or the FAFSA renewal form (available on-

line for continuing students: www.fafsa.ed.gov). There is no deadline for submission for new students. This

information will be used for consideration in awarding campus based funds. Parental information is required if you are

applying for need-based grants. Our Federal Code for the FAFSA is 002838-00. The 2017-18 FAFSA requires

income information from the 2015 tax year.

2. If you are applying for need-based grants, you must also complete the Need Based Grant Application. This

application includes a Financial Aid Transcript form (to be completed from your prior undergraduate and

graduate institutions) and requires additional information on your parents and spouse.

3. First year students and new financial aid applicants must complete this Institutional Application for Financial Aid; and

a Credit Policy Statement.

4. You should have already submitted the Citizen/Eligible Non-Citizen Verification Form to the Office of Admissions,

along with the required documentation.

5. If your application is selected for Quality Assurance verification, you will be required to submit Federal Tax forms, proof of

untaxed income (if any) and other documents as requested. You will be notified in writing if you have been selected.

6. Certain programs may require that additional financial information be collected before awards are made. You must be

prepared to submit this information if requested.

7. To facilitate loan processing and reduce the risk of lost paperwork, please make certain that your mailing address is

accurate.

8. All students should have a clean credit history, as some loan programs will check the credit-worthiness of applicants prior

to approval.

9. Stony Brook University participates in the Direct Lending Program for federal student loans (Stafford and Grad PLUS). All

borrowers must complete an online Federal Direct Loan Master Promissory Note (MPN). The MPN can be completed at:

https://studentloans.gov

Stony Brook is listed under “State University of New York at Stony Brook”

Federal Code: 002838-00

No financial aid will be awarded until applications and supporting documents are received. Send all forms to:

Stony Brook University

School of Medicine

Office of Student Affairs

HSC Level 4, Room 147

Stony Brook, NY 11794

631-444-2341

e-mail: [email protected]

Academic Year 2017-18

Name ____________________________________________________ SB ID # ________________________________

S.S. # _______________________ Entering Class Year ____________ Date of Birth _____________________

E-mail address: _________________________________________________________

Permanent Mailing Address ________________________________________________________________________________

Address for Correspondence _______________________________________________________________________________

Telephone _____________________________ State of Legal Residence _________________

Citizenship ____________________________ Type of Visa ___________________________

Marital Status __________________________ # Dependent children living w/you _________

During the 2017-18 academic year do you plan to live:

_____ with parents

_____on campus (_____ dorms, _____ apartment complex)

_____ apartment off campus, single;

_____apartment off campus, shared

_____own home.

Anticipated monthly rent or mortgage payment: __________________Anticipated Specialty_________________________

Educational Level of Parent/Guardian: Father _________________________ Mother _______________________________

Parent/Guardian Occupation: Father ________________________________ Mother________________________________

Have you previously received financial aid (including loans)? ___________

Please check the programs to which you are applying for the 2017-18 Academic Year:

Unsubsidized Stafford Loan – Federal Direct __________________________

Grad PLUS – Federal Direct __________________________

SUNY Disadvantaged Student Tuition Waiver __________________________

(MUST complete Parents’ Info Section of FAFSA and

Application for Need Based Grants)

Institutional Need Based Grant __________________________

(MUST complete Parents’ Info Section of FAFSA and

Application for Need Based Grants)

National Health Service Corps or Armed Forces HPSP _________________________

Federal income tax (parents’ and applicant/spouse) transcripts are required of all applicants for need based aid.. Go to:

https://www.irs.gov/individuals/get-transcript

Other (including personal loans from family) _________________________

Name of institutions previously attended: ______________________________________________________

____________________________________________________________________________________________________

Have you received a National Direct or Perkins Loan at another institution? _____________

Have you received a Pell Grant or SEOG at another institution? _____________

Will you have use of a car? ______________ Make/Model /Year __________________________________

Annual Insurance Premium __________________ Drivers License #_________________

Student’s and Spouses’ Indebtedness (include indebtedness of spouse-to-be):

Debt (lender and purpose) Total Amount Borrowed Amount to be repaid during

2017-18 Academic Year

______________________ _____________________ _________________________

Educational Loans:

_____________________ ______________________ _________________________

Total Educational Loans ______________________ _________________________

Total Indebtedness ______________________ _________________________

The State University of New York at Stony Brook does not discriminate on the basis of race, religion, sex, sexual preference,

color, national origin, age, disability, marital status, or status as a disabled or Vietnam-era veteran in its educational programs

or employment.

Discrimination is unlawful. If you are a student or an employee of SUNY at Stony Brook and you consider yourself to be a

victim of illegal discrimination, you may file a grievance in writing with the Affirmative Action Office within forty five calendar

days of the alleged discriminatory act. If you choose to file a complaint with the University, you do not lose your right to file

with an outside enforcement agency such as the State Division of Human Rights or Equal Employment Opportunity

Commission.

Signature __________________________________________ Date _____________________