Entrance Counseling Signature Page
Section I:    Please PRINT and complete Section I. See Section II and III for further instructions.
Your Name  
Social Security #  
School  
Please provide references of two persons who do NOT reside at your permanent address:
 

1st Reference

2nd Reference
Name    
Relationship    
Address    
City    
State    
Zip Code    
Telephone#    
Section II:   Perkins Loan Borrowers Only:
Perkins is a need based low interest federal loan program. Your school is the lender. Payment begins after a 9-month grace 
period once you graduate, leave school or your enrollment status becomes less than half-time. Perkins Loan borrowers are 
not charged fees. However, if you skip a payment, make a payment late, or make less than a full payment, you may have to 
pay a late charge. If your failure to make payments persists, you may also be charged collection costs.
Please review the following repayment information for this loan.

Date of Disbursement

Interest Rate

Minimum Payment
On or after October 1, 1992 and, on the date your loan was made you had no outstanding (unpaid) Perkins Loan balance from 07/01/65 to 09/30/92.

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5 percent

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$120 per quarter or $40 per month.
On or after October 1, 1992 and, on the date your loan was made you had an outstanding (unpaid) Perkins Loan balance from 07/01/65 to 09/30/92.

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5 percent

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$90 per quarter or $30 per month.
Section III:   Direct/Perkins Loan Borrowers:
Please click 'Entrance Counseling'  below, read the online Entrance Counseling information, complete the 
Entrance Counseling Quiz, print and return the "Rights and Responsibilities" page along with a signed copy of this Signature Page to this office. Loans will be credited to your account after the Office of Financial Aid receives both pages.

I acknowledge that I have read all online Entrance Interview information and understand
the terms of my student loan(s).

Student Signature _________________________________     Date ______________

Entrance Counseling