Part A. Participant Information
Part B. Education
Part C. Employment
Part D. Income Qualification - Total Household Gross Income

Your Income

Spouse Income (if applicable)

Part E. Program Interest & Desired Outcome
Part F. Signature & Understanding
  • I certify (promise) that all information on this application is true and correct. I understand that this information may be verified. I also understand that I may be asked to provide documentation to support information provided on this portion of the Nebraska Community College Assistance Application.
  • I understand that eligibility for Gap assistance shall not be construed to guarantee enrollment in any Gap program.
  • I understand this application is valid for six months from the date of signature on this application and that I cannot receive Gap assistance for more than one program.
  • I understand that if it is determined that funding for my participation in this program is available from any other public or private funding source, my application will be denied.
  • I am aware that if I purposely give false information, I may lose my Gap assistance and I may be prosecuted under any applicable State and Federal laws.
  • I grant permission to Southeast Community College to release information about my participation in the Gap Assistance Program to the Nebraska Postsecondary Coordinating Commission.

You will receive a confirmation email after your submission is received.