CAMERON UNIVERSITY
Unusual Enrollment History Verification
Academic Year 2015-2016
Your 2015–2016 Free Application for Federal Student Aid (FAFSA) has been flagged for “Unusual Enrollment History
Review” by the U.S. Department of Education because you have received Federal Pell Grant funds at multiple education
institutions during the past four academic years (2011-2012, 2012-13, 2013-14 and 2014-15). This flag requires
Cameron University to review your enrollment history and determine whether or not you are enrolling in an institution
long enough to have received aid without earning any academic credit towards degree completion. In the process of
reviewing your enrollment history, we will check the National Student Loan Data System (NSLDS) to obtain a complete
academic record including the name of institutions you have attended and the dates of attendance. You must complete
and sign this worksheet, attach any required documents, and submit the form to our office. Do not leave any questions
blank. If you are unable to provide the required transcripts, you must submit a signed and dated statement explaining
in detail why you are unable to provide the transcripts.
A. Student’s Information
_____________________________________________________________
Student’s Last Name
Student’s First Name
Student’s M.I.
____________________________________
Student’s ID Number
_____________________________________________________________
Student’s Street Address (include apt. no.)
____________________________________
Student’s Date of Birth
_____________________________________________________________
City
State
Zip Code
____________________________________
Student’s Email Address
_____________________________________________________________
Student’s Home Phone Number (include area code)
____________________________________
Student’s Alternate or Cell Phone Number
B. Colleges, Vocational Schools and other Postsecondary Institutions
Academic Year
EXAMPLE
2011-2012
Names of Schools, Institutions, Colleges,
etc.
Cameron University
Dates of Attendance
Aug 2012 thru May 2013
Transcript Submitted
to Cameron (Yes/No)
Yes
2012-2013
2013-2014
2014-2015
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Student ID:
C. Certification and Signatures
Each person signing this form certifies that all the
information reported on it is complete and correct.
Dependent students, he student and one parent must sign
and date.
WARNING:
If you purposely give false or
misleading information on this worksheet, you may
be fined, be sentenced to jail, or both.
Student’s Signature
Date
Parent’s Signature (if applicable)
Date
Submit this worksheet and required documents to:
Office of Financial Assistance
Cameron University – North Shepler #301
2800 West Gore Boulevard
Lawton, OK 73505-6320
FAX: 580-581-2556, Email: financialaid@cameron.edu
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