1. Consortium Agreement Contract
As allowed in part 668.19,Student Assistance General Provisions, and part 690.8, Pell Grant Program, Code of
Federal Regulations, this Consortium Agreement is entered into between Lehman College (home institution) and
________________________________________________ (host institution) for the purpose of providing financial
assistance to the student.
_______________________________________
SECTION 1 TO BE COMPLETED BY THE STUDENT
Name: ________________________________ Home ID: ___________________________
Address: ________________________________ Host ID: ____________________________
City: ________State __________ Zip __________ Phone: _____________________________
E-mail ___________________________________ Expected Term of enrollment__________
By signing this Consortium Agreement, I (the student) agree to:
 Notify the Financial Aid Office at Lehman College if there is a change in my enrollment status.
 Authorize the Host institution to release any required information to finalize my financial aid at Lehman College.
 Take responsibility for payment arrangement, charges and fees at the Host institution.
 Have all my financial aid processed only at Lehman College.
 Submit an official transcript to the Registrar Office at Lehman College confirming completion of course(s) for the
Term(s) attended.
Student Signature: ________________________________ Date: ________________________
________________________________________________
SECTION 2 TO BE COMPLETED BY THE ACADEMIC ADVISOR AT THE HOME
INSTITUTION
 This Consortium Agreement will allow Lehman College to disburse financial aid based on the student‘s
combined enrollment at both institutions.
 Lehman College is responsible for determining eligibility of awards,disbursing aid, monitoring academic
progress, keeping records,returning funds, and reporting federalrequirements.
 Lehman College agrees to accept the credits earned at the Host Institution.
______________________________________ _________________________________________
AuthorizedSignature & Date Printed Name and Title
______________________________________ __________________________________________
Course Name & Number Course Equivalent Cr. Value
1.__________________________________________________________________________________________
2.__________________________________________________________________________________________
3.__________________________________________________________________________________________
4. _________________________________________________________________________________________
Office of Financial Aid Phone:718-960-8545
Shuster Hall, Room 136 Fax: 718-960-2419
250 Bedford Park Blvd. West www.lehman.edu/financialaid
Bronx, NY 10468 financial.aid@mail.lehman.edu

2. Telephone Number E-mail
________________________
SECTION 3 TO BE COMPLETED BY THE HOST (VISITING) INSTITUTION
The studentlisted above is seeking a degree or certificate from Lehman College and plans to enroll atthe Hostinstitution
listed below for an equivalentcourse. The student is responsible for payment arrangement of all charges at the Host
institution.
UNDER THIS AGREEMENT, THE HOST INSTITUTION:
 Certifies that the above-referencedstudent is registeredduring the aforementioned enrollment period.
 Will notify Lehman College if the student withdraws or drops below the anticipated enrollment or presents any
issues that may affect the student eligibility to receive federalTitle IV and New York State (College Aid) award.
 Will not process or pay any federal or state college aid during the above enrollment period for the named Student
______________________________________ _________________________________________
AuthorizedSignature & Date Printed Name and Title
______________________________________ __________________________________________
Telephone Number E-mail
Host College Course Name & Number /Course Equivalent/ Cr. Value
Name of Host Institution: _______________________
Enrollment Period: Fall___ Spring___ Summer____ 1._________________________________________________
Dates of Enrollment: From__________ to _________
(M/D/Y) (M/D/Y) 2._________________________________________________
Number of Credits Enrolled: _______ 3._________________________________________________
Cost of Attendance for Academic Year: ____________ 4._________________________________________________
Institutional Budget for Campus-Based Financial Aid for Period enrollment __________________________________