Minnesota Loan Forgiveness and Repayment Program forms

Allied Health Care Faculty Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Dentist Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 29KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Nurse Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Nurse Faculty Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 14KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Rural Midlevel Practitioner Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Rural Pharmacist Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Rural Physician Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Rural Veterinarian Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 15KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Urban Physician Loan Forgiveness Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 13KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.


Minnesota State Loan Repayment Program

Affidavit of Practice Form must be completed annually as evidence of service obligation (PDF: 12KB/1 page).

Payment Verification Form must be completed annually to confirm funds have been applied to loans.

All programs: Payment Verification Form must be completed annually to confirm funds have been applied to loans.
Fillable Word: 87KB/1pg (complete online and email to Amy Vallery)

or print and complete
PDF: 65KB/1pg by hand

Updated Tuesday, 20-Sep-2011 08:59:09 CDT