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Verification of Student's Separation/Divorce

Send required documents to:

Fontbonne University

Financial Aid Office

6800 Wydown Blvd

St Louis MO 63105

fax: 314-889-1457

Student Information

First Name:
Last Name:
Last 4 Digits of Social Security Number:
Student ID Number:

Marital Status

Current Marital Status:
Date of Divorce/Separation:	example: MM/DD/YY

Separated

Are you covered by a Legal Separation?:	If yes, mail or fax documents to Fontbonne University
If NO, specify the conditions of your separation:
Student's Current Address:
Spouse's Current Address:

Divorced

Please mail or fax a copy of your divorce decree.

Please explain any special circumstances:

Electronic Signature

By submitting this online document, you certify that the information on this form is true and correct. You further understand that if you purposely give false or misleading information on this form in order to obtain financial assistance, that your financial aid will be cancelled and that you may be subject to fines, imprisonment, or both.

Please select one:

I Disagree

I Agree

Some required answers are missing or incorrect.