SUNY Brockport Educational Opportunity Program Transfer Verification Form

BROCKPORT

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EOP

EDUCATIONAL OPPORTUNITY PROGRAM

Transfer Verification Form

This form is to be completed by the EOP Director at the campus from which the applicant is transferring

EOP TRANSFER ELIGIBILITY

The student whose name appears on this form is applying for transfer admission to the State University of New York, Educational

Opportunity Program at State University College at Brockport. In general, transfer admission is available for students who

previously participated in a New York State Opportunity Program (Educational Opportunity Program (EOP), Higher Educational

Opportunity Program (HEOP) and, Search for Elevation Education and Knowledge/College Discovery (SEEK/CD). Please note that

previous program participation and meeting the eligibility criteria do not guarantee admission. Capacity, institutional fit, and overall

performance will be considered in the application review process.

Though the transfer option is intended primarily for students who began their college studies in a New York State Opportunity

Program, there are specific circumstances in which a student who is not in such a program may be accepted as a transfer.

INSTRUCTIONS

This form must be completed by the Educational Opportunity Program director or a campus professional at the college from which

the student is transferring. The person completing the form must be able to respond to questions regarding the student’s academic

and income eligibility, direct aid award payments, and overall participation in the program. Once completed, return the form to the

Educational Opportunity Program director at State University College at Brockport. To render a timely admission decision to the

student, please provide answers to all questions on the form.

Please return the form within seven business days of receipt.

PART 1. STUDENT INFORMATION

Applicant is applying for: Fall Semester Spring Semester Academic Year

Last Name First Name Middle Initial

Student ID College CEEB Code

Will the student earn an associate’s degree prior to transferring Yes No

Planned Academic Major

Number of Credits Earned

Current Cumulative GPA

The student is eligible for the Foster Youth College Success Initiative (FYCSI) per the guidelines Yes No

Note: The Foster Youth College Success Initiative is a New York State legislated program designed to alleviate the financial burden

of foster youth who are pursuing a college degree. While some colleges may provide academic and personal support services, the

principal feature of the FYCSI is the provision of financial assistance. Eligible students receive FYCSI direct aid to offset college

costs such as tuition, fees, books, supplies, housing, meals and transportation. In order to participate, students must provide

documentation to verify eligibility. For more information, you may contact the Educational Opportunity Program at the campus to

which the student is applying.

PART II. ENROLLMENT VERIFICATION (PLEASE CHECK ONE)

New York State Colleges & Universities

The student was admitted to a New York State EOP, HEOP, or College Discovery/SEEK Program.

We do not have an EOP, HEOP, or CD/SEEK program, but the student was admitted through a college access program

for economically and academically under-prepared students

We have a New York State EOP, HEOP, or College Discovery/SEEK Program, but the student was not admitted due

to ineligibility.

The student met the academic and financial criteria for opportunity program student eligibility, but was not admitted

due to limited capacity.

We have an Educational Opportunity Program, but the student did not submit an application for EOP and/or did not

notify the office of his/her eligibility to participate. Therefore, we are unable to verify the student’s EOP eligibility.

We do not offer an opportunity program or a similar program, but the student would have met the criteria for academic

and income eligibility. (Please contact the SUNY System Administration Office of Opportunity Programs to ascertain

previous year income guidelines, if necessary)

Colleges & Universities Outside of New York State

The student was admitted into a program with the same mission as the New York State Educational Opportunity

Program (e.g. ACT 101, EOF). Documentation is attached stating that the student was both financially and academically

disadvantaged at the time of admission.

The student was enrolled in a course of study at a college which has traditionally served underrepresented and

financially disadvantaged populations. Documentation is attached verifying that the student was both financially and

academically disadvantaged at the time of admission.

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Complete this section only if your campus has a New York State EOP, HEOP, or CD/SEEK Program

PART III. ACADEMIC BACKGROUND

Date of Admission to EOP: Fall Spring Summer

The student was enrolled in: EOP HEOP SEEK/CD

Are you aware of any institutions attended by the student prior to enrolling at your institution? If so, please specify:

PART IV. SEMESTERS OF ELIGIBILITY (TO BE COMPLETED ONLY BY SUNY CAMPUSES WITH EOP)

The Educational Opportunity Program policy guidelines restrict the number of semesters a student can receive EOP financial

support. In completing this section, please identify the terms the student received EOP direct aid at your campus regardless

of award level. Please do not list actual award amounts. Instead, simply indicate the year of direct aid payments.

(Please do not include any payments in connection with the pre-freshman summer program)

Term Term Term Term

Summer Fall Winter Spring

2. According to our records, the student has also received direct aid payments at the following SUNY Institutions:

Institution Name Term

The student used a total of terms of SUNY EOP direct aid funding.

Note: Educational Opportunity Program students are allowed ten semesters of EOP direct aid payments to pursue a

baccalaureate degree and six semesters to earn an associate’s degree. No more than ten semesters can be awarded in total

unless approved by the SUNY Office of Opportunity Programs.

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Complete this section only if your campus DOES NOT have a New York State EOP, HEOP, or CD/SEEK Program

PART V. STUDENT ENROLLMENT DATA

Date of Admission: Fall Spring Summer

High School Average (at time of application) Combined SAT Score ACT Composite

Date of Attendance From until

Month/Year Month/Year

Total Household Income at the Time of Admission

Total Household Size at the Time of Admission

At the time of admission, the student met both the academic and economic criteria for Opportunity Programs eligibility.

Documentation to that effect is on file.

Program Director/Staff:

Department:

Name of College/University:

Work Phone

Email Address

Signature Date:

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