SUNY Orange

Community College in the High School Program (CCHSP)
Scholarship Financial Verification Form


To be submitted by high school guidance counselor. Please complete the following:
 

____________________________ qualifies for free/reduced lunch. He/she will be in 
(Print Student�s Name)


the following SUNY Orange courses through the Community College in the High 


School Program (CCHSP) in the 2020-2021 academic year: _______________________

______________________________________________________________________________

______________________________________________________________________________

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Guidance Counselor___________________________________________________________
							(Print Name)

Guidance Counselor Email:			   Telephone:					
			

Guidance Counselor Signature:			   Date			


Please send completed form to:  Mary Ford, Director of Educational 
Partnerships, SUNY Orange, 115 South Street, Middletown, NY 10940. 
Phone: 845/772-1229, Fax: 845/341-4382, Email: mary.ford@sunyorange.edu