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. 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. 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. CAPTCHAEmailThis field is for validation purposes and should be left unchanged.