Financial Assistance Application

Comments

This field is for validation purposes and should be left unchanged.

Child's Information

Class Placement for this Application*

Child's Date of Birth*

Email

Phone

Household

What 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 members

Please list all siblings with their dates of birth and the names of adult dependents with the amount of support provided.

Parent/Guardian 1

Information must be provided for both parents, regardless of living situation or marital status.

Phone

If different from child's residence phone:

Employer*

Please enter the name of your employer:

Employer's Address and Phone number

Position Held

Length of Employment

Gross Annual Salary (before taxes)*

Parent/Guardian 2

Information must be provided for both parents, regardless of living situation or marital status.

Phone

If different from child's residence phone:

Employer

Please enter the name of your employer:

Employer's Address and Phone number

Position Held

Length of Employment

Gross Annual Salary (before taxes)

Other Sources of Household Income:

Family support

Amount per year from grandparents or other family members:

Amount per year of current loans/credit lines, including education loans for current students:

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:

Source of support:

Amount of any other income:

Source of support:

Extraordinary Expenses or Other Hardships

Please describe below

any 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:

Documentation

Please 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.

File

Max. file size: 64 MB.

File

Max. file size: 64 MB.

Certification

Signature