Please read the Rights and Responsibilities Summary Checklist.
I have attended exit counseling for subsidized Federal Direct Stafford/Ford Loan and Federal Direct Unsubsidized Stafford/Ford Loan borrowers. I have read, and I understand, my rights and responsibilities as a borrower, as listed herein. I also understand that I must repay my loan according to the terms of the promissory note.
| Student Information (Please Print Clearly) | |||
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Name (last, first, middle initial)
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Social Security Number Date of Birth
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Home Address (street, city, state, zip code)
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Home Area Code/Telephone Number
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Driver's License (state and number)
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Employer After Leaving School (if known)
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Employer's Area Code/Telephone Number
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Employer's Address (street, city, state, zip code)
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| References:You must list two persons, with different U.S. addresses, who will know your whereabouts for at least three years. | |||
| Name |
1. |
2. |
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| Street Address |
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| City, State, Zip Code |
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| Area Code/Telephone Number |
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Student Signature
Date