MEMORANDUM
 
From: Office of Student Financial Aid
 
RE: Authorization to use Federal Work-Study funds to help meet Educational Cost
 
 
Please retain Federal Work-Study to pay on my account to assist with meeting my
educational cost. This request is made without coercion. The amount being retained to help cover my bill is $
 
I understand that I can resend this request at any time.
 
 
Student’s Signature:
 
 
Printed Name:
 
 
Social Security Number:
 
 
Date:
 
 
[Ref: 34CFR675.16 and 34CFR675.16a(4)(I)]
 
 
 
Copyright © 2004 Miles College. All rights reserved.