TEXTBOOK ASSISTANCE PROGRAM - APPLICATION FOR ASSISTANCE Please note, this form must be completed each semester that you request textbook assistance.Name* First Last NSCC A#* Phone Number* Campus email*This must be your @my.nscc.edu email address Please select your main NSCC campus.*White Bridge RoadSoutheastClarksvilleDicksonWaverlyMadisonDo you currently qualify for Snap E&T Program?* Yes No but I am interested in signing up. No and I am NOT interested in signing up. The Supplemental Nutrition Assistance Program (SNAP) Employment and Training helps eligible participants achieve their vocational goals and increase self-sufficiency through funded education, skills training, and supportive services. SNAP E&T services are a combined effort between the Department of Human Services (TDHS), Department of Labor (TDLWD), and community partnerships. Have you completed the FAFSA?* Yes No Are you a Veteran student?* Yes No Are you a TN Promise student?* Yes No I don't know Are you a TN Reconnect student?* Yes No I don't know Do you participate in the Nashville GRAD Program?* Yes No If yes, you will receive textbook assistance through the Nashville Grad Program. Do you participate in the Nashville FLEX Program?* Yes No If yes, you will receive textbook assistance through the Nashville FLEX Program. Do you currently have a bus pass?* Yes No You will keep your current bus pass.. Terms and Conditions (By checking each box, you are indicating that you understand and accept the terms):* I understand that my textbook assistance award will be less the amount of my DCM (Digital Course Materials) that are automatically charged to my student account. I understand that if I choose to opt-out, my textbook assistance award cannot be used to cover vendors outside of the Nashville State Bookstore and I will be responsible for the cost of my books. I understand that priority is given to TN Reconnect students and those who pay out of pocket for tuition. I understand that the textbook assistance will be a percentage of my total textbook costs and not the full amount. I understand priority is given to student who have an unmet financial need. I understand I can purchase my textbooks after I have received my reward letter and instructions. I understand NSCC Foundation has the right to deny textbook assistance if I am receiving textbook assistance from another source. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.