Financial Assistance Application Financial Assistance Application Apply for tuition assistance. Child's InformationChild's Name* First Last Class Placement for this Application* Child's Date of Birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email PhoneHouseholdWhat is your ANNUAL HOUSEHOLD INCOME from all sources?*How much does your budget allow you to PAY EACH MONTH for preschool?*Every family must pay some tuition, according to its means. Awards are limited by the total of available funds. You may not receive the amount you request. How many people in your household?*Please include all dependents. Household membersPlease list all siblings with their dates of birth and the names of adult dependents with the amount of support provided. Parent/Guardian 1Information must be provided for both parents, regardless of living situation or marital status.Parent/Guardian 1* First Last Financial Responsibility*This adult has legal responsibility for this child, supporting the child in part or claiming as a dependent. Yes No Residence*This adult lives with this child: Full time Part-time (shared custody) No AddressIf different from the child's address. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneIf different from child's residence phone:Employer*Please enter the name of your employer: Employer's Address and Phone numberPosition Held Length of Employment Gross Annual Salary (before taxes)*Parent/Guardian 2Information must be provided for both parents, regardless of living situation or marital status.Parent/Guardian 2 First Last Financial ResponsibilityThis adult has legal responsibility for this child, supporting the child in part or claiming as a dependent. Yes No ResidenceThis adult lives with this child: Full time Part-time (shared custody) No AddressIf different from the child's address. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneIf different from child's residence phone:EmployerPlease enter the name of your employer: Employer's Address and Phone numberPosition Held Length of Employment Gross Annual Salary (before taxes)Other Sources of Household Income:Family supportAmount per year from grandparents or other family members:Amount per year of current loans/credit lines, including education loans for current students:Amount per year of current loans/credit lines, including education loans for current students:Amount of other financial assistance for children:Amount of other financial assistance for children:Sources of support:Please describe the sources of family support above. Amount of other scholarship or fellowship for either parent:Amount of other scholarship or fellowship for either parent:Source of support: Amount of any other income:Amount of any other income:Source of support: Extraordinary Expenses or Other HardshipsPlease describe belowany additional circumstances you would like us to consider, i.e. outstanding loans or debts, medical expenses, recent loss of employment or expected loss of income:DocumentationPlease attach to this application, pages 1-2 of your most recent federal tax return or, if unavailable, recent pay stubs. If unemployed, please submit a copy of your public aid card (AllKids card is not sufficient). If you are unable to provide this documentation, please contact the office to arrange alternative confirmation.FileMax. file size: 64 MB.FileMax. file size: 64 MB.CertificationConsent* By submitting this form, I certify that all of the above information is correct. I understand that the school's financial assistance fund is limited by the school's budget and ability to raise funding. I also agree that if my circumstances change, I will notify the school and adjust the amount of financial assistance I am receiving.*SignatureNameThis field is for validation purposes and should be left unchanged. Δ