2015 Family Assistance Application Form
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- Adelia Patrick
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1 2015 Family Assistance Application Form Westside Christian College is prepared to offer Family Assistance to families that face financial hardship. The Assistance is for one year only and for any future assistance an application must be made in each subsequent year. If you are having difficulty completing the form, contact the Business Office for assistance. 1. FAMILY DETAILS Please complete this form and lodge in a sealed envelope addressed to: The Business Manager Westside Christian College PO Box 282 Goodna QLD 4300 Where students are living with one parent/guardian, the address of the other parent/guardian must also be completed Surname: Given name(s): Address: P code P code Daytime Telephone: Mobile: Fax: 2. LEVEL OF ASSISTANCE REQUESTED 2015 COLLEGE TUITION FEES - Please use Fees Schedule for 2015 (attached) Note: Family Assistance only applies to Tuition Fees Student 1 Year Level in 2015 Tuition Fees Less Sibling Discount Less Scholarship (if applicable) Net Tuition Fees Student 2 Student 3 Student 4 Student 5 Total College Tuition Fees for the Year $ How much do you believe that you can set aside for payment of the above Tuition Fees in 2015? Assistance Requested for 2015* $ $ PLEASE NOTE: If this box is not completed your application form will not be considered and returned to you for completion. Tuition Resources, Transport, uniforms and other sundry charges are not subject to family assistance. WESTSIDE CHRISTIAN COLLEGE Page 1 of 9
2 3. FINANCIAL HARDSHIP Grants of Family Assistance are normally made only where a financial hardship may be demonstrated. It is important that the College families understand that certain types of events will not qualify in the first instance. Examples: Loss of Job Separation Divorce Accident Illness Natural Disaster Studying The College would usually expect the family member losing a job to be immediately searching for and finding a new job. A temporary delay from paying fees would be allowed in this circumstance rather than a grant of Family Assistance. A temporary delay from paying fees until the situation was sorted out A temporary delay from paying fees until the situation was sorted out A temporary delay from paying fees until insurances are settled A temporary delay from paying fees until Medicare, Sick Leave & Superannuation has been settled A temporary delay from paying fees until insurances are settled Where parents decide to take on full time study during the year of assistance applied for, the College will consider a temporary credit increase for that year of no more than 50% of the Tuition fees and with the security of a Guarantor. Parents taking on a course of study of more than one year are expected to have planned for the payment of fees ahead of making this decision. Please note that if a Family is using one of the above to support an application for Family Assistance then full supporting details should be attached. The Family Assistance Committee may ask for further supporting documentation. N.B. Temporary Delay means deferment. The fees must still be paid but at a later time. 4. REASONS FOR REQUESTING FAMILY SUPPORT ASSISTANCE Please note: It is not sufficient to say you require a Christian Education for your child/ren. You need to describe the particular circumstances which caused or are causing hardship for your family. It is extremely important that you carefully answer the questions below these answers advise the Family Assistance Committee on why and for how long you will need assistance. a. What are the circumstances that have made you apply for Family Assistance? _ b. How long do you see this situation continuing for and why? WESTSIDE CHRISTIAN COLLEGE Page 2 of 9
3 4. REASONS FOR REQUESTING FAMILY SUPPORT ASSISTANCE cont. c. What action are you taking to either stabilise your financial situation or improve it? d. Are there any other circumstances that the Family Assistance Committee should take into consideration when reviewing your application? e. Use this space below to add further details as necessary. (ie. Date of event, details of insurances, details of compensation etc.) Has any documentation in relation to the above comments been attached to this application? Yes / No 5. HEALTH CARE CARD Do you currently hold a Health Care Card? YES/NO If YES what is the expiry date? 6. STUDY Are you presently studying? FATHER MOTHER Full Time: YES / NO Full Time: YES / NO Part Time: YES / NO If yes.. Part Time: YES / NO If yes.. Institution Institution Course Course Estimated Date of Completion Estimated Date of Completion WESTSIDE CHRISTIAN COLLEGE Page 3 of 9
4 7. EMPLOYMENT DETAILS FATHER MOTHER Name of Employer: Address: P code P code Daytime Phone: Position Held: Years in Position: Are you currently Unemployed? YES / NO [Cross out that not applicable] If yes, How long? Years/Months/Weeks If unemployed more than one month, what action are you taking to find employment? If you will remain either on a pension or Centrelink payment for greater than 3 months please advise details: 8. BANKRUPTCY FATHER MOTHER Are you or have you ever been made a Bankrupt YES [ ] NO [ ] YES [ ] NO [ ] If so, at what stage of the Bankruptcy Process are you? a) Endeavouring to pay off debts? YES [ ] NO [ ] YES [ ] NO [ ] b) Undischarged? YES [ ] NO [ ] YES [ ] NO [ ] c) Discharged? YES [ ] NO [ ] YES [ ] NO [ ] 9. CREDIT REFERENCE Are you able to cite loans that demonstrate your ability to use credit properly i.e. You have maintained loan payments on a regular basis to pay the loan off. Please give details: If you will remain either on a pension or Centrelink payment for greater than 3 months please advise details: 10. DEBTS TO OTHER PRIVATE SCHOOLS Do you owe any money to other Private Schools for School Tuition Fees or Charges? YES [ ] NO [ ] If so give details WESTSIDE CHRISTIAN COLLEGE Page 4 of 9
5 11. INCOME AND EXPENDITURE If a certain category does not apply please enter N/A being not applicable. If you are a sole proprietor or run a family business then you should supply a copy of financial returns by your accountant. If Father and Mother both work then both columns must be completed. INCOME Per year 1). Total Salary Received (including any Salary Sacrifice) $ $ Less Salary Sacrifice amounts: 2). Superannuation $ $ 3). Car $ $ 4). Loans $ $ 5). Expenses $ $ 6). Etc $ $ Salary/Wages before tax =1-( ) $ $ Bonuses $ $ Net Income from Investments: Interest from Securities $ $ Dividends from Stocks and Shares $ $ Income/Rent from Property $ $ Capital Gains $ $ Income from Trusts $ $ Overseas Income $ $ Social Security Benefits: Pension $ Family Tax Benefit Part A (Including Large Family Supplement) $ $ Rent Assistance $ $ Family Tax Benefit Part B $ $ Child Care Benefit $ $ Child Support/Maintenance $ $ Abstudy/Austudy $ $ Rentals for Board or Homestay $ $ Foster Child income $ $ Other Income (Details required) $ $ TOTAL INCOME $ $ Per year WESTSIDE CHRISTIAN COLLEGE Page 5 of 9
6 11. INCOME AND EXPENDITURE cont. Please declare if your employer or business provides you with a motor vehicle for private use or part of your salary sacrifice: Yes No Please ensure all your income is declared on page 5, and supporting documentation attached. EXPENDITURE If father and mother both at same residence, only one column need be completed. Per year Per year Church Giving $ $ WCC College Fees $ $ Mortgage/House Rental $ $ Investment Loan Repayments $ $ Personal Loan Repayments $ $ Credit Card $ $ Insurance/Super Contributions $ $ Food $ $ Medical coverage/expenses $ $ Clothing $ $ Petrol/Transport Costs $ $ Transport of children to and from school $ $ Motor Vehicle Registration/Insurance/Repairs $ $ Electricity/Phone/Gas/Rates $ $ Entertainment $ $ School costs Other Children $ Child No. 1 $ $ Child No. 2 $ $ Child No. 3 $ $ Child Care $ $ Business Expenditure $ $ Other Give Details $ $ TOTAL EXPENSES $ $ Please ensure all your expenditure is declared above, and supporting documentation attached. WESTSIDE CHRISTIAN COLLEGE Page 6 of 9
7 12. ASSETS AT REALISTIC / MARKET VALUE Please ensure you declare all your assets. Where a category does not apply please mark as N/A. All questions should be answered. Cash on Hand $ $ Cash at Bank (eg Term Deposits) $ $ Motor Vehicle, Boats, Caravans etc $ $ House and Land $ $ House Contents $ $ Any Other Real Estate (eg Investment/Rental Property, Land, Business Property etc) $ $ Assets held in trust for you $ $ Superannuation $ $ Life Insurance policies $ $ Value of other Significant Assets (eg jewellery, gold bullion etc) $ $ Stocks and Shares $ $ Debts owed to you $ $ Business Assets (share in business) $ $ TOTAL ASSETS $ $ WESTSIDE CHRISTIAN COLLEGE Page 7 of 9
8 13. LIABILITIES / CURRENT FINANCIAL COMMITMENTS Please ensure you declare all your liabilities. Where a category does not apply please mark as N/A. All questions should be answered. Mortgage (current balance owing) (Bank ) $ $ Hire Purchase Agreement Balance Owing $ $ Personal Loan Outstanding Car 1 $ $ Car 2 $ $ Boat $ $ Other $ $ Investment Loans Property $ $ Investment Loans Shares $ $ Investment Loans - Other $ $ Credit Card balance outstanding $ $ Rent or lease Agreements $ $ Lay-by Agreements outstanding $ $ Debts outstanding to Creditors $ $ Any other liabilities $ $ $ $ $ $ TOTAL LIABILITIES $ $ 14. FINANCIAL FORECAST Your income and Expenditure for the 2015 Calendar year; Please provide a forecast for the financial year ending 30 June Total Income Total Expenditure $ $ These figures should be based on the figures supplied in Section 8, 9, 10 and 11 allowing for any foreseen improvement in your situation. WESTSIDE CHRISTIAN COLLEGE Page 8 of 9
9 15. BANK LOANS / FINANCE Given your current situation please describe what steps you have worked towards in finding alternate finance to pay your debts to the College. This would include Bank Loans, Equity Offsets and Credit Cards. 16. DECLARATION I / We Father/Guardian: (full name) Mother/Guardian: (full name) Declare that I/we have answered all questions in the above application form and that the answers are true and correct. Where information required is not applicable I/we have answered N/A. I/we have included supporting documentation listed below for my/our application. I/we apply for family assistance on yearly fees on the basis of the information supplied. Signed: Father/Guardian: Date / / Mother/Guardian: Date / / Witness: Name (please print) Signed Date / / DOCUMENTATION TO BE ATTACHED (as appropriate): Copy of last tax return lodged with the Australian Taxation Office Two (2) consecutive fortnightly pay slips Copy of recent rental property statement Any other documentation which may assist in the processing of this application Bank statements which verify Centrelink payments. If you are unable to provide a copy of the documents, forward the originals and these documents will be copied and returned to you. WESTSIDE CHRISTIAN COLLEGE Page 9 of 9
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