Financial Assistance Application

Transcription

1 Archbishop Edward A. McCarthy High School, the School, makes financial assistance available to all students who attend the School regardless of race, color, creed, disability or national origin. The financial assistance program takes the form of hardship assistance. Hardship assistance is determined based on financial need subsequent to the evaluation of the financial assistance application. All students applying for financial assistance must first go through the admissions process. Financial assistance applications will not be reviewed unless a student has been admitted to the School and is registered for the school year. All amounts granted for financial assistance are applied to the tuition rate only and cannot be applied to Capital Improvement or other fees. All students must apply to the Step Up for Students Program at and provide a copy of the confirmation page with this application. Financial assistance will be provided based on review and verification of financial information provided on the financial assistance application. ELIGIBILITY Students must meet the following requirements in order to be considered for financial assistance: 1. Financial assistance application completed and all required documents submitted to Mrs. Maria Perez in the Tuition Office in room The student must have and maintain a 2.5 grade point average. 3. The student must have and maintain a satisfactory disciplinary record. 4. All fees must be paid in full prior to applying for financial assistance. APPLICATION DEADLINE Submit your application as early as possible. The School has allocated a fixed amount of its budget toward providing financial assistance; therefore, these funds are limited and will be provided on a first come, first served basis. The deadline for submitting the application for the school year is May 1, USING YOUR TAX RETURN If the student and/or parents need to file a 2014 income tax return with the Internal Revenue Service (IRS), we recommend that you complete it before filling out this application. If you have not completed your return yet, you can submit your application using estimated tax information, and then correct the information after you file your return. However, in order to receive financial assistance, your 2014 tax return should be provided to the School no later than May 1, If your family has unusual circumstances that might affect your financial situation (such as loss of employment), complete this form to the extent that you can, then submit it with a letter explaining your financial situation.

2 Student Information Please print all information. Last Name: First Name: Middle Initial: Mailing Address: Apt. #: City: State: Zip Code: Home Phone: ( ) Cell Phone: ( ) Date of Birth: / / (mm/dd/yyyy) Social Security Number: Driver s License Number: Driver s License State: At the beginning of the school year, what grade level has the student completed? q8th grade q10th grade q9th grade q11th grade How much can your family afford to pay for tuition on a monthly basis? Will the student need a parking permit due to driving his/her car to school? qyes qno Vehicle Information Make: Model: Year: Tag #: Current Semester GPA: School Attended: For 2014, has the student completed an IRS income tax return? qreturn completed (provide copy) qwill file, but have not completed return qwill not file a return What income tax return did you file or will you file for 2014? qirs 1040 qirs 1040A or 1040EZ qforeign Tax Return qtax return with Puerto Rico, another US Territory or Freely Associated State What was your adjusted gross income for 2014? Enter your income tax amount for Enter your number of exemptions for How much did you earn from working in 2014? As of today, what is your total current balance of cash, savings, and checking accounts? As of today, what is the net worth of your investments, including real estate?

3 Parent Information Please print all information. Marital Status: qmarried or remarried qsingle qdivorced or separated qwidowed Month and year married or remarried, separated, divorced, or widowed: / FATHER/STEP-FATHER INFORMATION Last Name: First Name: Middle Initial: Mailing Address: Apt. #: City: State: Zip Code: Home Phone: ( ) Cell Phone: ( ) Date of Birth: / / (mm/dd/yyyy) Social Security Number: Driver s License Number: Driver s License State: Highest Level of Schooling Completed: qmiddle school/jr. High qcollege or beyond qhigh School qother For 2014, has the parent completed an IRS income tax return? qreturn completed (provide copy) qwill file, but have not completed return qwill not file a return What income tax return did you file or will you file for 2014? qirs 1040 qirs 1040A or 1040EZ qforeign Tax Return qtax return with Puerto Rico, another US Territory or Freely Associated State What was your adjusted gross income for 2014? Enter your income tax amount for Enter your number of exemptions for How much did you earn from working in 2014? As of today, what is your total current balance of cash, savings, and checking accounts? As of today, what is the net worth of your investments, including real estate? As of today, are you a dislocated worker? (laid off, self-employed but not working due to the economy) qyes qno

4 FATHER/STEP-FATHER INFORMATION (CONTINUED) Current Employer Company Name: Address: City: State: Zip Code: Type of Business: Gross Annual Salary: $ Position: Current Monthly Obligations Description: Amount: Balance Owed: MORTGAGE $. $. MORTGAGE $. $. Monthly Parish Contributions: Other Monthly Obligations:

5 FATHER/STEP-FATHER INFORMATION (CONTINUED) Financial Institution Name: Address: Type of Account: (check all that apply) qchecking qsavings qother Church Information Church Registered: Parish Involvement: Dependents/Obligations Do you have other children? qyes qno Are there any persons (other than children) for whom you provide? Parent Involvement/Volunteering at School: (List Activities)

6 MOTHER/STEP-MOTHER INFORMATION Last Name: First Name: Middle Initial: Mailing Address: Apt. #: City: State: Zip Code: Home Phone: ( ) Cell Phone: ( ) Date of Birth: / / (mm/dd/yyyy) Social Security Number: Driver s License Number: Driver s License State: Highest Level of Schooling Completed: qmiddle school/jr. High qcollege or beyond qhigh School qother For 2014, has the parent completed an IRS income tax return? qreturn completed (provide copy) qwill file, but have not completed return qwill not file a return What income tax return did you file or will you file for 2014? qirs 1040 qirs 1040A or 1040EZ qforeign Tax Return qtax return with Puerto Rico, another US Territory or Freely Associated State What was your adjusted gross income for 2014? Enter your income tax amount for Enter your number of exemptions for How much did you earn from working in 2014? As of today, what is your total current balance of cash, savings, and checking accounts? As of today, what is the net worth of your investments, including real estate? As of today, are you a dislocated worker? (laid off, self-employed but not working due to the economy) qyes qno

7 MOTHER/STEP-MOTHER INFORMATION (CONTINUED) Current Employer Company Name: Address: City: State: Zip Code: Type of Business: Gross Annual Salary: $ Position: Current Monthly Obligations Description: Amount: Balance Owed: MORTGAGE $. $. MORTGAGE $. $. Monthly Parish Contributions: Other Monthly Obligations:

8 MOTHER/STEP-MOTHER INFORMATION (CONTINUED) Financial Institution Name: Address: Type of Account: (check all that apply) qchecking qsavings qother Church Information Church Registered: Parish Involvement: Dependents/Obligations Do you have other children? qyes qno Are there any persons (other than children) for whom you provide? Parent Involvement/Volunteering at School: (List Activities)

9 Parent/Guardian/Student Agreement By signing this application you agree, if asked, to provide information that will verify the accuracy of your completed form. This information may include U.S. or state income tax forms that you filed or are required to file. Also, you certify that you understand that Archbishop Edward A. McCarthy High School has the authority to verify information reported on this application in any legal manner. You also understand that, if you purposely give false or misleading information, any financial assistance awarded may be revoked, the student may be asked to leave the school, and legal action may be taken at the discretion of the Principal and Supervising Principal. WE DECLARE THAT ALL INFORMATION ON THIS APPLICATION IS TRUE TO THE BEST OF OUR KNOWLEDGE AND AUTHORIZE ARCHBISHOP EDWARD A. MCCARTHY HIGH SCHOOL TO VERIFY ITS ACCURACY IN WHATEVER LEGAL MANNER MAY BE NECESSARY. Student s Signature: Date: Father s Signature: Date: Mother s Signature: Date:

10 REQUIRED DOCUMENTS 1. Completed Financial Assistance Application for Student s and Parents 2014 Tax Returns W-2 Forms Forms 5. Bank Statements for the most recent 3 months 6. Pay stubs for the most recent 3 months 7. Letter explaining your financial situation and any unusual circumstances that might affect your financial situation (i.e., loss of employment). Provide any supporting documentation (i.e., letter from previous employer or unemployment compensation claim check stub) which will further allow us to evaluate your situation. 8. Letter from your Pastor or Minister supporting your financial need. 9. After completing this application, make a copy of all pages and documents for your records, and submit in a sealed envelope to Mrs. Maria Perez in the Tuition Office, room 112. Questions regarding financial assistance application procedures may be directed to: Mrs. Maria Perez Tuition mjperez@mccarthyhigh.org All forms can be downloaded at: Archbishop Edward A. McCarthy High School, 5451 South Flamingo Road, Southwest Ranches, FL