University of South Carolina Beaufort
South Carolina HOPE Scholarship
Required Certification and Affidavit 2011-2012 Read, complete and sign this affidavit and return it to the address below. If you wish, you may fax the form to the number below. The completed and signed form must be returned to the Financial Aid Office. If this signed document is not returned, it will be assumed that you cannot or do not wish to sign and the HOPE Scholarship award will be rescinded.
As a South Carolina HOPE Scholarship recipient, I certify that I have never been convicted of any felonies. Further, I certify that I have not been convicted of a second or subsequent alcohol or other drug-related misdemeanor offense(s) during the preceding calendar year (defined as 12 months from the date of the start of school for the period of this award). If I am adjudicated delinquent or am convicted or plead guilty or nolo contendere to any felonies or any alcohol or drug-related misdemeanor offenses under the laws of this or any other state, I agree to notify the Financial Aid Office by the start of school. I hereby give permission for a background check to be conducted to verify the above. I understand additional information may be requested after the background check has been conducted. I understand that any false information provided or any attempt to expend any scholarship funds for unlawful purposes or any purpose other than in payment or reimbursement for the cost of attendance at the University of South Carolina Beaufort will be cause for immediate cancellation. I understand that a student who has obtained a scholarship through means of a willfully false statement or failure to reveal any material fact, condition, or circumstances affecting eligibility will be subject to applicable civil or criminal penalties, including retroactive loss of the scholarship. I also affirm that I am not currently in default on any Federal or State student loans nor do I owe any refunds to any Federal or State financial aid programs. Note: A response must be provided to one of the following statements: I certify that: (check one) I do not have an Associate or Bachelor Degree, Certificate or Diploma from a college or university. I received an Associate or Bachelor Degree, Certificate or Diploma from the below college or university: in Name of Institution
Month/Year Received
Print Full Name: ___________________________________ SSN (Last 4 numbers only): ____________ Signature: _____________________________________________ Date: ___________________________ Any changes in eligibility criteria will be posted on our website as well as on the website of the SC Commission on Higher Education at www.che.sc.gov. HOPE Scholarship certification requirements are based on current SC law. Any or all of these requirements are subject to change by the SC General Assembly without notice. UNIVERSITY OF SOUTH CAROLINA BEAUFORT Financial Aid Office 801 Carteret Street Beaufort, SC 29902 843-521-3104 Fax: 843-521-3194