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WARNING If you purposely give false or misleading information on this worksheet you may be fined be sentenced to jail or both. 2017/18 STUDENT HOUSING STATUS FORM OFFICE OF FINANCIAL AID 163 South Willard Street PO Box 670 Burlington Vermont 05402 P 802. 860. 2777 www. champlain.edu STUDENT INFORMATION PLEASE PRINT LAST NAME CHAMPLAIN COLLEGE ID NUMBER FIRST NAME MI ADDRESS DATE OF BIRTH CITY TELEPHON E NUMBER INCLUDE AREA CODE STATE ZIPCODE STUDENT HOUSING STATUS CERTIFICATION On the 2017/18...
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