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After you print and sign the form, bring the form to the Enrollment Services Office on the first floor of Lynnwood Hall, OR fax the form to 425-640-1159, OR mail the form to: 
Financial Aid Services Office 
Edmonds Community College 
20000 68th Ave W 
Lynnwood, WA 98036 

17-18 Request to Apply Without Parent Information
 Student Name     Last:      First:      M.I.: 
 Student ID Number:    --   Birthdate:  //   MM/DD/YYYY
   Social Security Number: --
Unless you meet certain criteria, you are considered dependent until the age of 24, even if you do not live with your parents, they do not support you, or they do not claim you on their taxes. Complete this form if the financial aid application [FAFSA (Free Application for Federal Student Aid) or WASFA (Washington Application for State Financial Aid)] is asking you for parent information and signature, but you have a serious situation that prevents you from obtaining this information. Based on your situation, we may be able to make an exception and allow you to apply for financial aid without parent information. We look at the relationship you have with your parent(s) and the situation that prevents you from obtaining the information.
Section A: Financial Aid Application
 You must complete the 2017-18 financial aid application online before we process your request.
  Yes, I have already submitted my 2017–18 FAFSA or WASFA application       No, I have not submitted my 2017–18 FAFSA or WASFA application
Section B: Household and Living Situation
Where did you live, or who provided support for you, in 2016? (check all that apply)
Parent Relative Friend Shelter Foster Care Guardian My Own Home/Apt. Charitable
Where do/will you live between July 2017 and June 2018? 
 Do you currently receive all or part of your living expenses (Room and Board) from an organization or individual?
    Yes       No 
 If yes, indicate the name and relationship to you:   Relationship 
Section C: Income Information
Indicate the monthly sources of income and resources you are currently receiving:
Employment Social Security Financial Aid Food Stamps Welfare Benefits Section 8 Housing Charitable Organization
$ $ $ $ $ $ $
 If you do not work or receive any of the benefits listed above, how do you support yourself?

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Section D: Complete the following sections that apply to you:
1. Serious Situation
 Do you currently have any contact with one or both of your parent(s)? Yes       No 
Provide the following:
  • A letter from you describing your serious situation and the relationship with your parents.
  • Two additional letters from professionals (teachers, counselors, health care provider, attorney, etc.) documenting your circumstances and what they know of your situation. Letters from friends or other family members are usually not enough to approve independent status, but if you include them, they will be reviewed and considered.
  • Any other legal documents that would help to confirm the situation with your parents.
2. Complete this section if you applied without parent information in the 2016-17 academic year.
 Do you now, or did you at any time during the previous year have contact with either of your parents?
       Yes    No

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 Is the situation and relationship with your parents the same now as it was when you previously applied for approval?       Yes    No

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3. Other Legal Situations
    Provide a letter explaining your situation AND legal documents if any of the following applies to you:
  • Emancipated Minor
  • In Legal Guardianship
  • In Foster Care or Ward of the Court, at any time since the age of 13
  • Homeless anytime on or after July 1, 2016 (provide letter from shelter or School District homeless liason)
Section E: Certification – Sign this form
 By signing below, you certify that all of the information reported on this form is complete and correct. The information on this form, and documents and information related to this form are used to determine eligibility for federal, state and institutional financial aid. If you give false or misleading information on this form or other documents, you may be fined, sentenced to jail, or both.
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