Unaccompanied Homeless Youth Verification

Unaccompanied Homeless Youth Verification

Financial Aid Office: 902 Herring Ave PO Box 4305 Wilson, NC 27893 Phone (252) 291-1195 Fax (252) 243-7148
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Student ID
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Signature giving consent to disclose information to Wilson Community College

Clear
Date
I am providing this letter of verification as a (check one):

McKinney-Vento high school or school district liaisonDirector or designee of a HUD-funded emergency shelter or transitional housing programDirector or designee of a RHYA runaway or homeless youth basic center or transitional living program
As per the College Cost Reduction and Access Act (Public Law 110-84), I am authorized to verify this student's living situation. No further verification by a Financial Aid Administrator is necessary. Should you have additional questions or need more information about this student, please contact me at the number listed below.
This letter is to confirm that (name of student)First Name Last Name was:
Check one:

An unaccompanied homeless youth after July 1st of the previous year, living in a homeless situation, as defined by Section 725 of the McKinney-Vento Act, and was not in the physical custody of a parent or guardian.An unaccompanied, self-supporting youth at risk of homelessness after July 1st of the previous year. This means that, after July 1st of the previous year, he/she was not in the physical custody of a parent or guardian, provides for his/her own living expenses entirely on his/her own, and is at risk of losing his/her housing.
Date of Determination

MonthDayYear
Date
Authorized Signature of Official

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Print Name

First NameLast Name
Title
Date

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Agency
Should be Empty: