UW-Platteville Collaborative Engineering
Financial Aid
Consortium Agreement Form
Student:
Today’s Date:
Social Security #:
Semester/Year:
Visiting Campus:
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This agreement confirms UW-Platteville as the “Home” campus (from which the student intends
to graduate) and identifies which campus shall be considered “Visiting.”
UW-Platteville agrees to award financial aid to the student utilizing the costs of the Visiting
campus to determine program eligibility.
The Visiting campus agrees to furnish UW-Platteville with the total number of credits for which
the student has enrolled, the cost of tuition and fees, and to inform UW-Platteville of any
course/credit changes, refunds or withdrawals.
The Financial Aid Office at the Visiting campus will not provide any aid to the student for the
period of attendance noted above.
COMPLETED BY VISITING CAMPUS FINANCIAL AID REPRESENTATIVE:
This is to certify that as of this date the above named student has enrolled for credits for the
session indicated above as a Visiting student (Guest Matriculant).
The student’s cost for this session in Tuition & Fees is: $__________________
Staff Name
Campus
Signature
Office Phone #
Date
Email Address
Please return this form to the UW-Platteville Financial Aid Office
husermi@uwplatt.edu
608.342.1836