Application Eligibility Type
I am applying for the State of Georgia Post-Secondary Tuition Waiver under Georgia Code Sections 20-3-66 and 20-3-660 under the eligibility of (select one):
In selecting the eligibility type above, I certify that I have carefully reviewed the eligibility criteria outlined in Code Section 20-3-66 and 20-3-660, along with the Certification and Affidavit found at the bottom of this application.
Student information
NAME:
PREVIOUS NAME(S) (If applicable and known):
PHYSICAL ADDRESS
MAILING ADDRESS (if different from Physical Address):
ELIGIBILITY INFORMATION
Please Note: This information will be verified by the State of Georgia Tuition Waiver participating agencies and institutions.
Have you ever been in foster care within Georgia?
EDUCATION HISTORY
Education
*POST-SECONDARY EDUCATION INSTITUTION INFORMATION
Note: At this time, only schools within the Technical College System of Georgia are participating in the Tuition Waiver Program.
Name of Institution:
DEGREE TYPE SOUGHT (select one):
ARE YOU SEEKING ON-CAMPUS HOUSING PROVIDED BY THE COLLEGE (select one):
Note: Only North Georgia Technical College and South Georgia Technical College are providing on-campus housing for students at this time.
*CERTIFICATION STATEMENT AND AFFADAVIT
I understand that if my eligibility is approved, I will be unable to participate in the John H. Chafee Education and Training Voucher (ETV) program at the same time. The John H. Chafee Education and Training Voucher is for current or former youth and young adults who have experienced foster care. Additional information regarding Georgia’s ETV program can be found here: https://embarkgeorgia.org/etv.
The information I provided in this application and on this Certification and Affidavit are subject to penalties for withholding or providing false information, including but not limited to, criminal penalties for false swearing pursuant to O.C.G.A. §16-10-71 for program fraud. I certify, under penalty of perjury, that the information I have given is correct and complete to the best of my knowledge. I authorize the release of any information necessary to determine eligibility and service provision for the support or assistance I have requested.
Any person who intentionally makes or furnishes a false statement or misrepresentation on this application, or on any form or writing hereafter furnished for use in connection with this application, and any person who accepts or uses the same knowing it to be false, for the purpose of enabling the student to establish eligibility for, or to wrongfully receive, state student aid funds, may be subject to fine or imprisonment, or both, under provisions of Georgia law.
My eligibility determination based on my application will also be sent to the Technical College System of Georgia institutional representative.
By signing electronically, I certify that the information given is correct and complete to the best of my knowledge.