Stafford Loan Request Form

The combination of subsidized and unsubsidized Stafford Loans cannot exceed your cost of attendance minus any other financial assitance you may be receiving and the program's annual and cumulative loan limits. The loan amount requested on this form may be reduced based on these limits.
Please provide the following contact information:
1. Student's Last Name
2. Student's First Name
3. Street Address
4. City
5. State
6. Zip Code
7. Home Phone
8. Email
9. Empl ID
10. Type of loan requested
11. Loan Amount Requested:
12. Loan Period
Lender and Guarantee Agency Information
Lender's Name
Lender Code
Guarantee Agency's Name
Upon submitting this form I authorize UND to credit excess financial aid toward outstanding allowable institutional charges other than tuition, fees, and contracted room and board (books, supplies, student health charges, parking fees, etc.) I understand that this authorization is voluntary and that if I do not authorize direct crediting, I may experience delays in receiving my financial aid and I will not be allowed to charge books at the University Bookstore.
Additional Comments or Questions

You may submit by using the "Submit" button listed below, or print and mail to the address in the lower right corner, or fax to: (701) 777-4942.

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UND School of Medicine & Health Sciences
501 N. Columbia Rd.
Grand Forks, ND 58202-9037
Student Financial Aid (701) 777-2849
Student Financial Aid Email: jthorv@medicine.nodak.edu