Initial Request for Financial Assistance Requests for financial assistance are considered based on eligibility, need, number of applicants and funds available for distribution. Any requests approved in whole or part for one school term should not be considered a guarantee or promise of future funding from the Trust. Applicants should make every effort to secure funding from other sources. 1. NAME: Last First MI Suffix 2. ADDRESS: 3. Email: 4. Alternate email: 5. Preferred phone number: 6. School you will be attending next term? 7. Highest education level you've completed? 8. Your cumulative grade point average? ( out of ) 9. Degree, certification or training you're pursuing? 10. Total hours or courses required for the program?
11. Of the total above, how many hours or courses have you completed? 12. Total amount being requested from the Trust for next term? $ (Date the money is due to the school? / / ) a. Of the amount in 12 above, how much is tuition? b. Books? c. Fees (including application and lab)? d. Housing? e. Meals? 13. Your current marital status (check one): Single Married Separated Divorced or widowed 14. Your income last year (joint income if married) 15. Your income YTD (joint income if married) 16. Your total liquid assets: cash, savings, checking accounts, etc. (joint assets if married)
17. Does anyone (parent/guardian) claim you as a dependent on their IRS forms? Yes (If Yes, complete questions 18, 19, 20 unless you will not be receiving any financial assistance from your parent/guardian. No (Skip to question 21.) 18. Parent/Guardian income last year? 19. Parent/Guardian income YTD? 20. Parent/Guardian liquid assets (cash, checking, savings, etc.)? 21. What other financial aid (loans or grants) are you receiving for the upcoming term? 22. Other financial aid (loans or grants) you have applied for?
23. Have you completed the FAFSA? Yes (provide details amounts received, etc) No and don t plan to (this may disqualify you) Not yet, but will (Please apply after you ve submitted your FAFSA) 24. Trace your ancestry to a sibling of Judith Gail Johnston 25. An essay is encouraged to communicate your goals and how this education or training will help you achieve them.
SIGNATURE PAGE Information on completing the application forms and submitting your request: 1. What documentation can you include to verify the information provided? Acceptable documentation could include tax forms, registration confirmation from school, grade report from school, transcripts, invoices from the school. 2. The Trust has limited funds and will consider eligibility along with need and academic achievement. 3. Once you have contacted us to request financial assistance, we will work with you in a courteous and respectful manner to get the information we need to be able to evaluate your request promptly. 4. Help us give you a timely response by providing a complete form with supporting documents. This can eliminate the need for the Trust to request additional information which will delay the review process. 5. If the Trust has agreed to provide funding, we will attempt to continue to provide funding for the duration of your education/training as long as you maintain at least a C average (2.0 GPA out of 4.0). ============================================================================ Attestation: All information I've provided to the Trust including the information on the Request for Financial Assistance (Initial or Continuing) is true and correct to the best of my knowledge. Legal signature: Print name: Date signed: Signature of parent or Guardian if under18: Print name: (parent/guardian) Date signed: (parent/guardian) ============================================================================ Application Checklist: 1. Review the eligibility requirements 2. Review and update the Family Tree as needed 3. Complete an application form 4. Submit supporting documents that verify the application information