PCE Pre-Application Income and Expense Worksheet

Transcription

1 PCE Pre-Application Income and Expense Worksheet A copy of this worksheet is to be provided to each prospective PCE grant applicant by the sponsoring chapter prior to the interview. It may be printed and mailed or downloaded and ed as an attachment with instructions to bring the completed worksheet to the interview. Because this worksheet is a copy of the actual online Income and Expense Statement, many of the builtin features of the online form will not function in this PDF version (i.e. tab to fill, drop down boxes, tool tip feature indicated by, start term/end dates and auto-sum data fields of all line items in each income and expense section). Once the online Chapter Recommendation Form and Letter has been submitted, the PCE project supervisor will the applicant with instructions and a link for accessing the online version of this form along with the application form. In order to qualify for a PCE grant, you must demonstrate financial need but also be able to show the trustees that you have a financial plan and/or the financial resources available to reach your educational goal within your stated program completion date. This Income and Expense Statement, or BUDGET, should reflect your income, your personal and household expenses and your financial aid and educational expenses during the term, or time period, for which the grant will be used. Remember You are applying for a grant to help cover your educational costs for the NEXT term in your course of study. This could be a semester, quarter, trimester or possibly a group of classes taken over the span of a month or more. Monthly Income The Monthly Income section should include all sources of income used to support the household during each month of the term, or time period, for which the grant will be used. Either enter the monthly amount or, if no income for that category, check Does Not Apply. Funds received from state or federal government are to be listed under State, Provincial, U.S., or Canadian Government Assistance. If you have additional sources of income not categorized, include under Other Sources of Income. PCE Income & Expense Worksheet 1 5/2015

2 SALARY: Net income only. If someone other than a spouse contributes income toward the household expenses, include the source and amount under Other Sources of Income. Applicant: Will you be working while attending school? Yes No If yes, indicate place of employment and the corresponding monthly salary. Source Spouse: Will your spouse be working while you are attending school? Yes No If yes, indicate place of employment and the corresponding monthly salary. Source Source Source PCE Income & Expense Worksheet 2 5/2015

3 List any monthly income form sources not already included in the specific categories above. DO NOT include educational financial aid in this section!!! If you are using excess financial aid to help cover your living expenses, please explain the source and list the amount under the essay question at the bottom of this form. For example: Unemployment Benefits; WIC; Social Security including SSD, SSI; Retirement; Survivor benefits; Financial assistance from o Family or friends; o Housemate sharing expenses; Rental income from second home; Home equity loan, etc. Do not include a PCE Grant as a source of income. Source Total Monthly Household Income: $ PCE Income & Expense Worksheet 3 5/2015

4 Monthly Expense The Monthly Expense section should include all of the bills and household expenses that will be paid each month of the term, or time period, for which the grant will be used. Either enter the monthly amount or, if no expense for that category, check Does Not Apply. If you have any additional expenses not categorized, list under Other Expenses. PCE Income & Expense Worksheet 4 5/2015

5 This list should include any monthly expenses not already included in the specific categories above. For example: School tuition for other members of your family; Entertainment; Charitable donations/giving; Activities; Child support payments; Any educational expenses not included in list approved for grant use (See: Educational Expense section of this form). List Total Monthly Household Expenses: $ Additional Financial Information PCE Income & Expense Worksheet 5 5/2015

6 Balance of Past Educational Loan(s): This figure should include any educational loan debt incurred from previous educational programs as well as any additional educational loan debt you have accumulated to date in this current course of study. Total Past Educational Loan Debt: $ Total Balance of Indebtedness: $ Financial Aid and Other Sources of Income to Cover Educational Expense Per Term Financial Aid and Other Sources of Income Per Term: This section should include your financial aid and all sources of income used to pay for your education for the term, or time period, for which the grant will be used. This should include any FAFSA in the form of grants or loans, even if they are paid directly to the educational institution you are attending. The form will automatically convert these figures into monthly income. Date Term Begins: (mm/dd/yyyy) Date Term Ends: (mm/dd/yyyy) Number of months in term or period of time for which the grant is requested: Financial Aid (confirmed): This section should include all of the Scholarships/Grants and/or Loans you have been awarded and accepted that will be used to pay your tuition and other educational expenses for this term. (Note: DO NOT include a PCE grant as a part of your financial aid.) Name Type PCE Income & Expense Worksheet 6 5/2015

7 Financial Aid (unconfirmed): This section should include those Scholarships/Grants you have applied for and have a reasonable certainty of receiving though your award notification is not yet in hand and/or loans you have been awarded but not yet accepted. (DO NOT duplicate loan amounts from your confirmed financial aid.) Name Type Other Sources of Income to be used for Educational Expenses: Include specific figures from any additional sources of income that will be used to cover the cost of your education for this term such as: Tuition reimbursement; Savings; Family assistance; Home equity loan; Investment income; Withdrawl from 401K, etc.; Name Total of Financial aid and other sources of income for the term the grant is requested: $ PCE Income & Expense Worksheet 7 5/2015

8 Educational Expenses Per Term: The figures below should reflect the cost of your education for the term, or time period, for which the grant is being requested. DO NOT include expenses for any of the following items in this section of the form as they are not approved uses of the grant. However, they may be included under the "Other Expenses" box in the monthly household section of this form. Cost of motel/additional housing stays; Food while on campus; Airline tickets to attend class, seminars or training; Car maintenance or repairs; Name Total of Educational Expense for the term the Grant is Requested: $ PCE Income & Expense Worksheet 8 5/2015

9 The Number of months in the term is calculated to the.10 of a month using the specific Date Term Begins and Date Term Ends you supplied to the chapter. If these dates are not accurate, please make adjustments as needed. If you change to an earlier start term date, it may make you ineligible for grant consideration for this term. Check each total surplus or deficit figure carefully. If this is not a true representation of your monthly surplus or shortfall, review the Household Income/Expense sections and Educational Expense/Financial Aid sections and make adjustments as needed before submitting this form! (Note: A dash {-} in front of the number indicates a monthly deficit.) While a perfect balance between income and expenses is not necessary or expected, the trustees of the P.E.O. Program for Continuing Education must see that there will be sufficient resources available for completing your educational program within the 24 month eligibility requirement for this grant. Unless this is your final term or you show a monthly surplus, provide your realistic financial plan for completing your education on schedule. (200 word limit) PCE Income & Expense Worksheet 9 5/2015

10 Please explain any unusual monthly expenses: e.g. excessive food expense or other high monthly payments. (100 word limit) The comparison of your total monthly income versus your total monthly expenses indicates a monthly deficit of $. Outline the additional steps you will take to address this shortfall so that you can remain enrolled in school until the completion of your program of study. Do not reference the use of a PCE grant in your comments. (100 word limit) The supervisor of the P.E.O. Program for Continuing Education and the trustees will share your name with donor of grants only with your permission. Refusing to check yes will in no way affect the decision of the trustees. I give my permission to the project supervisor or the trustees to share my name with the sponsor of my grant: Yes No PCE Income & Expense Worksheet 10 5/2015