Financial Assistance Request Form

Financial Assistance Request Form

Continuing Education & Workforce Development
Tuition assistance for non-credit courses comes from the State of Maryland, Federal and/or County agencies, and the FCC Foundation. Depending upon your plan and circumstances, you may be eligible for tuition assistance or student support funds. Availability of scholarship funds will vary based on funding levels and is not guaranteed until an award letter is received from the scholarship source.

Please complete the information below, making sure to check any boxes that describe your current status. FCC will evaluate your eligibility and contact you within 48 hours. For questions, please contact CEWD Registration at CERequest@frederick.edu
Do you have a CEWD Student Profile/Account?*

YesNo
Before completing this application, please create a student profile.

Create student profile
Student's Name*

First NameLast Name
Student's Email*
example@example.com
Student ID #*
Date of Birth*

MonthDayYear
Best Contact Number*
Enter the best number where we can contact you.Format: (000) 000-0000.
Home Address*
City*
State*
Zip Code*
County*
I am enrolled in or plan to enroll in (please check all that apply):*

Business & CareersCertification & LicensureComputers & TechnologyHealthcare CareersHospitality, Culinary & TourismTrades & Vocational TrainingUndecidedOther
My residential status is (please check all that apply):*

I am a citizen of the United StatesI live in Frederick CountyI have lived in Maryland for at least three (3) monthsI am eligible to work in MarylandNone of the aboveOther
I am Active Duty U.S. Military:*

YesNo
I am a Maryland high school graduate:*

YesNo
Are you currently working with Frederick County Workforce Services to receive any career training assistance?*

YesNo
Signature and Acknowledgement

Student or Parent/Guardian Signature
Select your preferred signature method:*

Typed (enter your name)Drawn (use your mouse or touch screen)
Signature

Clear
Name

First NameLast Name
Date*

MonthDayYear
Office Use Only
Date Received by CEWD Financial Coordinator

MonthDayYear
Date of CEWD Financial Coordinator Initial Outreach to Student

MonthDayYear
Notes/Comments
Date of Decision

MonthDayYear
Student eligible to pursue:

Community Foundation Of Frederick CountyWDSSFCC FoundationFCWSMD Promise: Non-credit programs
Other outcomes:

Student Not EligibleStudent Never RespondedStudent Declined
Frederick Community College
7932 Opossumtown Pike • Frederick, MD 21702
301.846.2400 • frederick.edu

Frederick Community College (FCC) prohibits discrimination against any person on the basis of age, ancestry, citizenship status, color, creed, ethnicity, gender identity and expression, genetic information, marital status, mental or physical disability, national origin, race, religious affiliation, sex, sexual orientation, or veteran status in its activities, admissions, educational programs, and employment. Under the ADA and Section 504, FCC makes every effort to accommodate individuals with disabilities for College-sponsored events and programs. For FCC employees needing accommodations, including interpreting, email humanresources@frederick.edu. For students and others with accommodation needs or questions, call 301-846-2408, or to request sign language interpreter services, please email interpreting@frederick.edu. Sign language interpreters will not be automatically provided for College-sponsored events without a request for services. Requests must be made at least five workdays before a scheduled event to guarantee accommodations. If your request pertains to accessible transportation for a College-sponsored trip, please submit your request at least 21 calendar days in advance. Requests made less than 21 calendar days in advance may not be able to be guaranteed.
frederick.edu/accommodations
3/17/26
Should be Empty:

Financial Assistance Request Form

Signature and Acknowledgement

Office Use Only