DOCUMENTS ARE REQUIRED BY MARCH 10, 2016
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1 The deadline for the submission of all Tuition Forms is MARCH 10, Failure to comply with this deadline will result in a $300 per child late filing penalty and your child(ren) placed on a waiting list. COPIES OF THE FOLLOWING DOCUMENTS MUST BE SUBMITTED WITH THE APPLICATION PLEASE CHECK ALL THAT APPLY DOCUMENTS ARE REQUIRED BY MARCH 10, Income Tax Notice(s) Of Assessment (2015 if available) Separation/Divorce Agreement. (If Applicable) T4( s) from 2015 Last pay statement(s) for 2015 showing Year To Date values or Two Most Current Consecutive Pay Slips Housing: Current Mortgage Statement at December 31, 2015 OR current Lease Agreement If a NEW home was purchased since February INCLUDE: Statement of Adjustments Mortgage Application Tax Free Savings Account (TFSA) Statement(s) Most Current Property Tax Assessment Registered Educational Savings Plan (RESP) Statement(s) Registered Retirement Savings Plan RRSP Statement(s) COPIES OF THE FOLLOWING DOCUMENTS ARE REQUIRED BY MAY 20, 2016 Complete Income Tax Return(s) For 2015 Include T4 s, schedules and etc. If this a first time application, please include 2014 Family Trust Returns. (If Applicable) Latest Year-End Accountant Prepared Financial Statements P&L, Balance Sheet, Cash Flow Statement, Etc. (If Applicable) Other Information May be Requested PLEASE ENSURE YOUR NAME AND ADDRESS ARE INCLUDED ON ALL DOCUMENTATION SUBMITTED Applications are assessed in chronological order when all documentation required is received. Failure to comply with the deadlines WILL result in the school not being able to guarantee a space for your child. First time Tuition SupportApplicants MUST provide Income Tax information from 2014 and 2015 PARENT / GUARDIAN INFORMATION Marital Status: Married Separated Divorced Re-Married Widow(er) Other Parent/Guardian #1 Parent/Guardian #2 Relation to Child Last Name First Name City Province Postal Code Phones: Home Cell Relation to Child Last Name First Name City Postal Code Phones: Home Cell Profession Business Information Profession Business Information Occupation Occupation Employer s: Name Employer s: Name Type of Business Type of Business Phone Phone Children Reside With 1 2 Both Correspondence sent to 1 2 Both 1
2 Name Age School Grade Tuition Fee 2015/2016 APPLICATION FOR TUITION SUPPORT PLEASE LIST ALL DEPENDANT CHILDREN THAT ATTENDED ANY SCHOOL OR CHILD CARE AS APPLICABLE IN 2015/2016 THE UJA FEDERATION PROVIDES SIGNIFICANT FUNDING FOR JEWISH EDUCATION INCLUDING TUITION SUPPORT. INCOME INFORMATION Total Income ( To Be Confirmed By The 2015 Income Tax Returns ) Income Line Father ($) Mother ($) Child ($) Total ($) Total Employment Earnings 101 Other Employment Income 104 Unemployment Insurance Benefits(T4u) 119 Taxable Amount Of Dividends 120 Interest And Other Investment Income 121 Rental Income 126 Taxable Capital Gains 127 Alimony Or Maintenance Income 128 RRSP Income 129 Other Income (Specify) 130 Net Self Employed Income (Specify ) Total Income ( Add Entire Column ) 150 Other Income: Gifts Or Other Assistance Tax Free Allowances (Eg: Car, Housing) Disability Benefits Income From Child Tax Benefit Total (Including Other Income) Total Estimated Income
3 Real Estate: Primary Residence APPLICATION FOR TUITION SUPPORT ASSETS: Purchase Date Purchase Price Approximate Current Value Was A Mortgage Taken Out To Finance The Purchase Of Your Home? Yes No Mortgages Please include copies of all current mortgage statements 1 st 2 nd 3 rd Amount Rate (APR%) Monthly Payment Term (Years) Property Tax Assessment Attach ALL Mortgage Documents Mortgage Held By: Do You Derive Rental Income From Your Home? Yes If Yes: Amount/Mo $ No OTHER REAL ESTATE Include Property in Other Countries Type\ Purchase Tax Purpose Price Assessment Current Value Was A Mortgage Taken Out To Finance These Properties? Yes No Mortgages Please include copies of all current mortgage statements Amount Rate (APR%) Monthly Payment Term (Years) 3
4 Registered Retirement Savings Plans: (RRSP) (Include copies of most recent statements) Father: Amount Invested 2015 $ Current Total RRSP Value $ Mother: Amount Invested 2015 $ Current Total RRSP Value $ Registered Educational Savings Plan (RESP (Include copies of most recent statements) Aggregate amount invested for all children in 2015 $ Current total RESP value for all children $ Cars, Trucks and other Vehicles (Owned or Operated in the Family): Year/Make/Model Plate # Date Purchased Purchase Lease \Finance Amount Price Cost per month Owing Company Car $ $ $ Yes No $ $ $ Yes No $ $ $ Yes No Bank Balances, Stocks, Bonds, GICs, TFSAs, Limited Partnerships and other Securities/Investments (including in other countries): Description Purchase Date Purchase Amount Current Value/Balance $ $ $ $ $ $ Intangible Assets (eg: taxi/limo license, royalties etc.) Description Market Value $ $ Businesses- Incorporated and unincorporated in which you or an immediate member of your family have an ownership interest: ( Submit financial statement with application ): Name of business % owned Current Value ( of % owned ) % $ % $ Do you or any member of your family have an interest in a trust or estate? If so : Family member Description Current Value Annual Distribution $ $ 4
5 FINANCIAL INFORMATION - FAMILY EXPENDITURES I Expenditures I Deductions from Line 150 Income Canada Pension Plan Credit Union Loan Credit Union Savings Group Insurance Premiums Income Tax (Line Total Father's And Mother's) Registered Pension Plan Contributions Unemployment Insurance Premiums Food and Sundries General Household Supplies Groceries Laundry, Dry Cleaning Dining Out Housing Mortgage Real Property Taxes (Include copy of Property Tax Assessment) Rent-----Paid To: (Include copy of Lease Agreement) Home Insurance Premiums Electricity Heating Repairs And Maintenance Cable TV Telephone Internet Access Water Gardening And Snow Removal Savings Registered Retirement Savings Plan Contributions Unreimbursed Health Costs (Including Drugs) Dentist (Regular Care) Doctors, Chiropractors Prescription Drugs Group Insurance Premiums Or Private Health Life Insurance Premiums Orthodontist Or Special Dental Care PLEASE TOTAL Subtotal I 2015 Actual 2016 Estimated Enter Monthly or Annual $ Enter Monthly or Annual $ Monthly Annual Monthly Annual 5
6 Expenditures II (continued) Clothing Children Parents Miscellaneous Alimony And Maintenance Paid Annual Union, Professional, Or Like Dues Babysitting, Daycare, Housekeeper Bar/Bat Mitzvah Camp - Child: Camp: Camp - Child: Camp: Camp - Child: Camp: Charitable Contributions (other than from tuition fees) Child In Other Educational Institute (Including University & Yeshiva) Where: 1) 2) Children s Activities- Specify: Children s Allowances Children's Tutoring Specify: Daycare And/Or Pre-School Fees Gifts Recreation/Entertainment Alimony/child support (Include copy of settlement agreement) Support To Parents/Family. Specify: Synagogue Dues Tuition, Fees, Books, Etc. Vacation- Where? 1: 2: 3: Transportation Car Insurance Premiums Gasoline, Oil Parking Public Transit Taxis, Car Pools Loan Payments Banks/Line of Credit Balance Car Loan/Lease Payment Vehicle 1: Yr: Car Loan/Lease Payment Vehicle 2: Yr: Credit Unions Finance Companies Credit Card 1 Type Credit Card 2 Type Taxes Owing (Arrears) Other Model: Model: PLEASE TOTAL Subtotal II ( This Page ) PLEASE TOTAL Subtotal I ( Previous Page ) PLEASE TOTAL Total (Subtotals I + II) TOTAL LOAN 2015 Actual Payments Enter Monthly or Annual $ 2016 Estimated Payments Enter Monthly or Annual $ Monthly Annual Monthly Annual 2015 Actual Payments 2016 Estimated Payments Monthly Annual Monthly Annual 6
7 Special Circumstances you wish to point out (attach a letter or other documentation if applicable). I/We are unable to pay the full tuition fee and therefore request tuition support. We OFFER to pay a Family tuition fee of $ for the school year for all our children registered in the Jewish Day School system including both the elementary and high school levels in grades I/We understand that this offer is solely for my children attending both the elementary and high school levels grades 1-12 and does not include the cost of Pre School that is not subsidized in all schools. Junior Kindergarten (JK) and Senior Kindergarten(SK) at Associated are eligible for tuition support and offer the amount of $ for the school year for our children in attendance of JK and or SK Student expenses not included in the Grades JK-12 tuition fee will be the direct responsibility of the parents. We hereby verify that all information is complete and correct. We understand that the information will be reviewed and is subject to verification by the tuition committee and may be required to meet with a member(s) of the tuition committee. We further understand that the tuition committee will upon completion of this review notify us of the tuition amount the committee has determined appropriate as a family fee. I\We understand that any misrepresentation or non disclosure may void any agreed tuition and the school has the option to reevaluate the tuition, revoke any subsidy awarded or refuse admission to the school. Income and subsidy information and the assessment by this committee are subject to review by The Centre for Jewish Education. All information submitted and the results of this review are treated as strictly confidential. In submitting and signing this application form, we acknowledge and consent to the sharing of this information with members of the tuition committee, The Julia and Hemry Koschitzky, Centre for Jewish Education, and, in the case of families with children at more than one Jewish day school or, in the case of children who transfer to another Jewish day school, the professional staff and tuition committee members at the other Jewish day school(s). Signature of Father / Guardian Signature of Mother / Guardian Date: / / Date: / / day month yr. day month yr. ANY MISSING INFORMATION, DOCUMENTATION OR SIGNATURES WILL RENDER THIS APPLICATION INCOMPLETE AND MAY NOT BE PROCESSED UNTIL ALL REQUIRED INFORMATION IS RECEIVED In order to receive an Admit To Class Card In August all outstanding tuition accounts must in good standing prior to July 31, The UJA Federation provides significant funding for Jewish Education including tuition support. 7
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