Listed below is the full range of forms that may be needed to complete the financial aid processes.
The latest version of Adobe Reader is required to view and complete the following forms.
- Employee Tuition Discount & BSMH Tuition Assistance Program Direct Billing Form
- BSMCON students, who are also BSMH associates will be identified by completing this form. Within the form students will select which program they are enrolled in and submit certain employment information (i.e.: Workday ID number, Facility/Location/Hospital, Cost Center - 123456 MRMC Emergency Room) in addition to employment status (i.e.: full-time, part-time or PRN) status. All students who submit the Employee Discount Form will be automatically included in the Direct Bill to BSMH HR. In such case, you will see a new fund source on your Registration Bill, “BSMH Tuition Assistance”. The amount of Tuition Assistance will be predetermined based on (1) submission of Employee Discount Form and (2) confirmation of employment, eligibility and annual limits through BSMH HR. Students will confirm Tuition Assistance on their Registration Bill available 30 days prior to the start of each Semester. Students who do not wish to participate in direct billing between BSMCON and HR will need to opt-out by contacting the Bursar and Associate Services (HR).
- PLEASE NOTE: All BSMH associates utilizing the BSMH Tuition Assistance Program are required to read and understand all related BSMH Tuition Assistance policies which can be found at HR ServiceNow at HRServiceNow.BSMHealth.org.
- HR ServiceNow – How to submit a Tuition Application or Request for Reimbursement
- FAQ for Tuition Assistance for All BSMH Associates
Request to Borrow Less Than Maximum Aid
- Request to Borrow Less Than Maximum Federal Student Loans
- Students with a completed FAFSA will be awarded the maximum federal financial aid they are eligible for. If you prefer not to borrow maximum loans, we also offer the option to borrow only what you need by completing this form.
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.
- 2021-2022 400/401 Dependent Verification Form
- 2021-2021 V1 Dependent Verification
- 2021-2022 V5 Dependent Verification
- 2021-2022 400/401 Independent Verification Form
- 2021-2022 V1 Independent Verification
- 2021-2022 V5 Independent Verification
Verification of Unusual Tax Circumstances Form
This form is applicable to students or parent with the following circumstance:
- Student or parent filed a foreign tax return
- Student or parent are victim of identity theft
Students who reported little to no income on the FAFSA for themselves or their parent, if dependent must complete this form. Independent students must show $12,000 in income or support, as well as $4,400 for each dependent. Dependent students and their parents must show $13,000 in income or support, as well as $4,400 for each dependent
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.
Verification of Conflicting Information – Student Marital Status Confirmation Form
Student must provide completed form when there is a discrepancy between the marital status listed on the FAFSA and received documentation.
Verification of Conflicting Information – Parental Marital Status Confirmation Form
Parent 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
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.
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 StudentAid.gov page.
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.