Pennsylvania Institute of Technology 800 MANCHESTER AVENUE  MEDIA, PA 19063-4098 (610) 892-1500 (800) 422-0025 www.pit.edu

PARENT PLUS LOAN AUTHORIZATION FORM

Dear Parent,

Your child has applied for Federal Student Financial Aid to attend our school. Based upon Federal regulations he or she has been determined to be a “DEPENDENT” student. This does not mean that he or she is actually dependent upon you for support, it only means that because of his or her age, marital status, and lack of dependents, the Federal Student Financial Aid Programs require you to provide your income and family information to determine his/her eligibility for assistance.

Please note that “DEPENDENT” students sometimes qualify for more financial aid than “INDEPENDENT” students. In addition, you will not be liable for any Grants or Loans your son/daughter qualifies for. However, you may qualify for the Parent PLUS Loan program, and you would liable for those loans.

Please complete the following information and sign the bottom of this form. This will assist us with packaging your son/daughter’s financial aid. We will use this information to determine what your son/daughter qualifies for and to determine if you are eligible to participate in the PLUS Program.

If you qualify for the Plus Loan Program please select whether you will take out the Plus Loan for your son/daughter by checking the box below:

I wish to take out this loan for my son/daughter. Parent’s Initials ______

______Student’s Full Name Date of Birth (please print) Student’s Social Security Number

______Parent’s Full Name (please print) Parent’s Social Security Number

______Street Address Parent’s Date of Birth

______City State Zip Code Home Phone Number

By signing below, I authorize Pennsylvania Institute of Technology and its affiliates to obtain a report on my credit to determine if I am eligible to participate in the Parent Plus Loan Program. I further authorize the Pennsylvania Institute of Technology to obtain subsequent credit checks if my son/daughter attends another semester and the credit check has expired. Credit checks expire after 180 days.

______Parent’s Signature Date

“The Technology College of the Delaware Valley”