FINANCIAL AID APPLICATION for Tikvah, ECE, HYC, Camp, and JCC Maccabi Games and ArtsFest

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1 FINANCIAL AID APPLICATION for Tikvah, ECE, HYC, Camp, and JCC Maccabi Games and ArtsFest Financial Aid Checklist In order for this application to be reviewed, you must be registered in the program and submit the required deposit for each child for whom you are applying for financial assistance. No financial aid applications will be reviewed unless all registration/enrollment forms and a program deposit have been received and processed. After the financial aid application has been completed, sign the application and attach the following items: a Copies of your past two Federal Income Tax Return (1040 with all Federal schedules only) for all parents/guardians, including W-2 forms and 1099s for all parents/guardians Note¹ a Copies of monthly mortgage statement or copies of receipts for rent checks for two consecutive current months or copies of current rental contract a Statement of need (page 4) If parents do not live together, both parents must complete financial aid applications and submit required documentation. Submittal Dates and Process You are responsible for ensuring that your financial aid package is received no later than the dates below corresponding to the program to which you are applying. Please note that incomplete packages will not be processed and an award may not be made. Maccabi Experience ECE Camp HYC Tikvah Submission Deadline March 14, 2014 April 11, 2014 March 28, 2014 May 9, 2014 August 15, 2014 Award Letters Sent March 24, 2014 April 21, 2014 April 8, 2014 May 19, 2014 August 25, 2014 To protect your privacy and ensure timely processing of your application, return the completed package only to: JCCSF Financial Aid Administrator 3200 California Street San Francisco, CA You can the application as an attachment to or fax it securely to If you have any questions about the financial aid process, please forward them to Please retain a copy of this application for your records. We look forward to welcoming your child. Note 1 If your most recent calendar year tax return is not completed, submit an estimated tax return (draft) and most recent calendar year W-2s and 1099s.

2 FINANCIAL AID APPLICATION: Child Information Child name: Age: c Female c Male Birth date: My child considers him/herself, entirely or in part, to be Jewish: c Yes c No c Prefer not to answer School: c Public c Private Grade as of next Fall: Programs covered by this financial aid application (Please circle applicable): Tuition: Tikvah, ECE, HYC Fee / Tuition = $ Summer Camp, Maccabi: Fee / Tuition = $ Extended Day Care (Preschool or Camp)*: Fee / Tuition = $ 1. TOTAL COST: TOTAL Fee / Tuition = $ 2. WHAT COST WILL YOU COVER? The scholarship committee expects families to contribute toward fees. a. Amount that family can contribute towards total tuition/program fees: $ b. Funding from grandparent or relative: $ c. Funding from other scholarship source: $ d. Total contribution (add Lines 2a through 2c): $ 3. TOTAL SCHOLARSHIP REQUESTED (subtract Line 2d from Line 1): $ Child name: Age: c Female c Male Birth date: My child considers him/herself, entirely or in part, to be Jewish: c Yes c No c Prefer not to answer School: c Public c Private Grade as of next Fall: Programs covered by this financial aid application (Please circle applicable): Tuition: Tikvah, ECE, HYC Fee / Tuition = $ Summer Camp, Maccabi: Fee / Tuition = $ Extended Day Care (Preschool or Camp)*: Fee / Tuition = $ 1. TOTAL COST: TOTAL Fee / Tuition = $ 2. WHAT COST WILL YOU COVER? The scholarship committee expects families to contribute toward fees. a. Amount that family can contribute towards total tuition/program fees: $ b. Funding from grandparent or relative: $ c. Funding from other scholarship source: $ d. Total contribution (add Lines 2a through 2c): $ 3. TOTAL SCHOLARSHIP REQUESTED (subtract Line 2d from Line 1): $ *Financial Aid is not available for after-camp swim lessons. PAGE 1 of 4

3 FINANCIAL AID APPLICATION: Family Information PARENT 1 c Male c Female c Parent c Stepparent c Guardian c Other PARENT 2 c Male c Female c Parent c Stepparent c Guardian c Other Name: Name: Address: Address: City, County, Zip: City, County, Zip: Home Phone: Home Phone: Cell Phone: Cell Phone: Work Phone: Work Phone: Relationship between Parent 1 and Parent 2: c Married c Separated c Divorced c Partner c Other Parent 1 Tax return filing status: Parent 2 Tax return filing status: c Married c Head of Household c Single c Married c Head of Household c Single Who claims the applicant for tax purposes? c Both c Parent 1 c Parent 2 c Parent 1 / Parent 2 alternate years Total exemptions claimed on most recent federal tax return? Parent(s) + Children + Other = TOTAL List all education expenses for all members of the household (including day care, private school and college) Member of Household School Name Current Grade Annual Tuition [Box A] Annual Financial Assistance from All Sources [Box B] Parent Pays Annually [Box C = A-B] TOTAL PAGE 2 of 4

4 FINANCIAL AID APPLICATION: Financial Information Please complete the information below, entering 0 if the category does not apply ANNUAL INCOME (NOT MONTHLY) AMOUNT AVERAGE MONTHLY EXPENSES* AMOUNT Parent 1 Gross Wages Rent or Mortgage (include real estate taxes) Parent 2 Gross Wages Recurring Household Expenses (e.g. food, utilities, etc.) Interest Income Medical Out-of-Pocket Expenses Dividend Income Auto Loan or Lease Payments Alimony Income Gas, Car Insurance, Maintenance, Local Transportation Business Income (Schedule C) Alimony and Child Support Expense Capital Gain / Loss (Schedule D) Pensions, Annuities & IRA Distributions Monthly Tuition Expense (day care, private school, college, etc.) Refer to BOX C on PAGE 2. Divide total by 12 months. Real Estate Income / Loss (Sch E, pg 1) Children s Extracurricular Expenses (sports, lessons, tutoring, etc.) Partnerships, S-Corps, Trusts & Estates Other Insurance Expenses Unemployment, Disability, VA Benefits Other Expenses (please itemize) Social Security Food Stamps, Other Government Assistance Child Support Income Indirect Child Support (expenses paid by others on behalf of your child) TOTAL ANNUAL INCOME $ TOTAL MONTHLY EXPENSES $ *Exclude credit card debt. Investment Real Estate Owned (EXCLUDE PRIMARY RESIDENCE) Address, City, State, Zip Date of Purchase Purchase Price Current Mortgages Current Value PAGE 3 of 4

5 An explanation of your family s financial circumstances is a mandatory part of this application for financial aid. STATEMENT OF NEED: Describe any changes in family or economic circumstances over the past year that support your request for financial aid this year. Include known events that will impact your family. If a parent has lost their job or work hours were reduced, please indicate the date, the estimated cost of this change and which parent (one or both parents) was affected. ADMINISTRATIVE USE ONLY: Parent(s) whose information is represented in the application must sign below to indicate they have read and agreed to the following terms. I hereby certify that all information provided in this application is true, correct and complete. I authorize the JCCSF to make anonymous and share this information with one or more scholarship committees for the purpose of granting a scholarship award. I further authorize the JCCSF to make additional inquiries they consider necessary to assure accuracy of the information provided. Parent 1 / Guardian signature: Date: Parent 2 / Guardian signature: Date: PAGE 4 of 4

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