Listed below is the full range of forms that may be needed to complete the financial aid processes.
 

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Financial Aid Request Form

To request Financial Aid, students will need to complete the Financial Aid Request Form and complete a 2019/2020 FAFSA.

BSHSI Employees
 

  • Bon Secours Virginia Student Loan Payback Benefit Program

    Recent graduates of Bon Secours Memorial College of Nursing can be eligible for this program once the graduate has successfully passed all licensing requirements and becomes employed as a new RN in Bon Secours Virginia, and within 90 days of graduation. 
     
  • Tuition Discount Form

    This awards a 20% discount to tuition for nursing courses taken at the college. This award is for students who are employees or legal dependent (per IRS code) of employees for Bon Secours Health System, Inc. with an employment status of full, part-time, or PRN.

    For returning students: This form must be signed, and received 30 calendar days before the start of every semester to be valid. 

    First semester BSMCON students: This form must be signed, and received prior to the first day of class to be valid. 

Verification Documentation

Students should review their Verification Notification that was sent to their BSMCON email to ensure they select the accurate form/s below. Verification Documents must have a handwritten signature; an electronic signature will not be accepted. 

Dependent Students

Independent Students

Verification of Unusual Tax Circumstances Form
This form is applicable to students or parent with the following circumstance:

  • Independent Student or Parent of Dependent students that were not required to file
  • Student or parent filed a foreign tax return
  • Student or parent are required to file, and will file
  • Student or parent filed an amended tax return
  • Student or parent are victim of identity theft


Data Mismatch Resolution Forms

Bachelor's Degree Verification
Required if there is a discrepancy between documents received by the Office of Financial Aid and the student's FAFSA in regards to if the student has obtained a prior bachelor's degree.

Change of Name Form
Students must provide completed form and attach approved government issued identification if they change their name. The document and attachments are returned to the Office of the Registrar.

Citizenship Verification Form
Student must provide completed form along with acceptable form of original identification if the FAFSA is unable to confirm citizenship with the Department of Homeland Security.

Marital Status Form
Student must provide completed form when there is a discrepancy between the marital status listed on the FAFSA and received documentation. 

Request for Veteran Information 
This form provides directions on how to resolve a data conflict on the completed FAFSA when the Department of Veteran Affairs (VA) did not match and confirm that a student is a veteran. 

Selective Service Registration Verification 
This form must be completed if the FAFSA reported that student failed to register for Selective Services.

Billing or Benefit Documentation 

Outside Scholarship Form
Required for students who are receiving funds from any organization that is not affiliated with the college or through the Bon Secours Richmond Health Care Foundation. 

Third Party Authorization for Billing
Required if student needs to have a third party billed to cover educational expenses. You must print, sign, scan and email this form, with all requested attachments to: BSR-Bursar

Title IV Credit Balance Authorization Form
This form authorizes student and/or parent to retain a Title IV credit balance on their behalf to be applied to future semesters within the current academic year. Student and/or parent should complete this form and return to the Bursar: BSR-Bursar

Veteran Enrollment Certification 
This form must be completed and submitted in advance of each semester for students who wish to utilize Veteran Benefits. You must print, sign, scan and email this form, with all requested attachments to: Shawn Ruppert

W9 form for Parent PLUS Loan Borrowers 
This form is required for any PLUS loan borrower (parent) that would like to receive any excess funds from the student's account. This form will allow the college to pay the parent borrower directly and not to the student. PLUS loan borrowers should complete this form and return to the Bursar: BSR-Bursar

Please note: This form is separate from the Direct Deposit Form. If the parent borrower wishes to receive the excess funds via Direct Deposit, reference that section and follow those directions. Without a Direct Deposit form, the parent borrower will receive a paper check sent to the address on the borrower's Master Promissory Note.

Miscellaneous Forms

Direct Deposit Form for Refunds/Stipends
This form authorizes BSMCON to deposit any amounts owed to the student by depositing into the student's account at his/her financial institution. Students should complete this form, along with a voided check or ask their bank to provide them with documentation of the Routing/Transit Number for their account. Return to the Bursar:BSR-Bursar

PLUS Loan Request Form
This form is required for a parent borrower to receive a PLUS loan. This form will need to be completed along with a credit approval and a Master Promissory Note completed by the parent borrower. Click the Direct Plus Loan Application to access information on the StudentLoans.gov page.

Appeal Forms

Adjust Cost of Attendance Appeal Form 
Use this form to appeal and address special circumstances which may impact you eligibility for aid. If you have additional expenses which exceed the standard cost of attendance for this academic year, you may appeal to have your Cost of Attendance (COA) reviewed. Please be aware that additional aid is not guaranteed. 

Income Appeal for Consideration of Special or Extraordinary Circumstances
Use this form to report a change in family situation that is not addressed on the Free Application for Federal Student Aid (FAFSA). The FAFSA uses financial data from the prior tax year to establish eligibility for financial aid. Special circumstance appeals are reviewed on a case by case basis. Please be aware that additional aid is not guaranteed.

Satisfactory Academic Progress Appeal Form
A student who is ineligible for federal financial aid due to not meeting Satisfactory Academic Progress requirements may appeal his/her ineligibility by completing this form.

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