STUDENT DIRECT DEPOSIT FORM FOR FEDERAL STUDENT AID

STUDENT DIRECT DEPOSIT FORM FOR FEDERAL STUDENT AID
Federal Student Aid is disbursed via direct deposit. Please complete this form and return to the Student Financial Services Manager along with a voided check or direct deposit form from your banking institution for your checking/savings account - NOT A DEPOSIT SLIP. If your funds will be deposited into a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn't always the same as the number on a savings deposit slip. This will help ensure your funds are deposited in the correct account.
STUDENT INFORMATION
Name*

First NameLast Name
SSN*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
BANK ACCOUNT INFORMATION
The total net amount of your check will be deposited to the following:
Bank Name*
City and State*
City and state of your banking institution
Account Type*

CheckingSavings
Routing/Transit Number*
Account Number*
STUDENT ACKNOWLEDGEMENT
Upload voided check or direct deposit form here:*

Cancelof
Ihereby authorize Goodwill Technical College (hereinafter "College") to deposit any amounts owed me by initiating credit entries to my account at the financial institutions (hereinafter "Bank") indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by College to my account. If College deposits funds erroneously into my account, I authorize College to debit my account for an amount not to exceed the original amount of the erroneous credit. This authorization is to remain in full force and effect until College and Bank have received written notice from me of its termination in such time and in such manner as to afford College and Bank reasonable opportunity to act on it. I understand that Goodwill Industries of Southeastern Louisiana, Inc. requires at least seven (7) days prior notice in order to cancel this authorization. I also understand that completing this form does not guarantee that I will receive a federal student aid refund.
Student Signature*

Clear
Date

MonthDayYear
Date
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STUDENT DIRECT DEPOSIT FORM FOR FEDERAL STUDENT AID

STUDENT INFORMATION

BANK ACCOUNT INFORMATION

STUDENT ACKNOWLEDGEMENT