MMUF Loan Repayment Application

MMUF Loan Repayment Application

Submit this form to request MMUF loan repayment. Ensure all required documents are uploaded before submission.
Name*

First NameLast Name
Primary Email*
example@university.edu
Emory Student ID #
ATTENTION: Ensure Your Personal Information and Mailing Address Are Up to Date!

It is very important that all alumni ensure their personal information (legal name, mailing address, and contact information) is up to date in OPUS. Failure to do so may result in missing funds or significant payment delays. Please take a moment to verify your details and update them if necessary.

You can update your information through OPUS at http://opus.emory.edu.
Graduate Field of Study*
PhD Program Entry Date*

MonthDayYear
PhD Completion Date or Expected Date of Completion*

MonthDayYear
PerkinsStaffordParent PLUSOther – College Loan Program
Lender's Name / Loan Provider(s)*
Eligibility Confirmation*

Verification of Previous MMUF Loan Repayments
YesNo
If yes, estimated date of MOST RECENT payment:

MonthDayYear
Total amount received:
Note: The information you provide here will be used to verify our current payment records, ensuring accurate and timely remittance of funds and preventing any under or overpayment.

Required Loan Documentation
Note: All Emory forms can be accessed and downloaded from our website.
Supplier Information Form

Cancelof
ACH/Direct Deposit Authorization Form

Cancelof
Statement of Total Loan Indebtedness*

This information should come directly from your lender and/or loan account. Screenshots are acceptable.
Cancelof
Proof of Full-Time Graduate Study
Note: All alumni currently completing a PhD must complete the Graduate Student Verification (GSV) form in order for their loan repayment application to be processed.

The GSV form must be signed by an authorized person:
- Director of Graduate Studies for your PhD program
- Department chair of your PhD program
- Graduate institution’s Registrar’s Office
Graduate Study Verification Form (for students completing PhDs)

Cancelof
University Transcript (for students completing PhDs – must be enrolled full-time)

Cancelof
Photocopy of PhD Degree (for 1-time payments of $5,000 or $10,000)

Cancelof
Note: Alumni who have completed their doctoral study and earned their PhD must only submit a photocopy of their earned degree. The Graduate Study Verification Form (GSV) and transcript are not needed in this case.

Confirmation of Accuracy and Completeness
ATTENTION: Loan repayment funds will only be reviewed and processed once all required documents have been completed and submitted. Failure to submit a necessary form may result in disruptions or delays in processing your request.

Please visit our Loan Repayment page to determine which forms and documents are needed when applying for funds.

For questions or inquiries, contact Naomi Diemer, MMUF senior program coordinator, at naomi.love.diemer@emory.edu.
By checking this box, I confirm that all information provided is accurate and complete to the best of my knowledge.*
Should be Empty:

Verification of Previous MMUF Loan Repayments