Financial Aid Application

Transcription

1 Use this form if applying to any of the following programs: ECE HYC JCC Maccabi Games and ArtsFest Summer Camp Tikvah School of Music & Dance Instructions 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. If parents do not live together, both parents must complete a financial aid application and submit all required documentation. Complete the enclosed financial aid application (pages 1 4), sign the application (page 4) and attach the following items: a Copies of the past two Federal Income Tax Returns (1040 with all Federal schedules only) including W-2 forms and 1099s for all parents/guardians* a Copies of monthly mortgage statements or copies of receipts for rent checks for two consecutive current months or copies of current rental contract a Statement of Need (page 4) Submit application and all required documents by the dates outlined below. 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. JCC Maccabi Games and ArtsFest (2015) Summer Camp (2015) ECE HYC Tikvah School of Music & Dance Submission Deadline Friday, March 13, 2015 Friday, March 27, 2015 Friday, April 10, 2015 Friday, May 8, 2015 Friday, August 21, 2015 Award Letters Sent Monday, March 23, 2015 Monday, April 6, 2015 Monday, April 20, 2015 Monday, May 18, 2015 Monday, August 31, 2015 Return the completed package by mail with attention to: JCCSF Financial Aid Administrator 3200 California Street San Francisco, CA Or the application as an attachment to financialaid@jccsf.org, or fax it securely to If you have any questions about the financial aid process, please financialaid@jccsf.org. *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 Child Information CHILD 1 Child Last Name: Child First Name: Age: Gender: Birth Date: School: My child considers him/herself, entirely or in part, to be Jewish: c Yes c No c Prefer not to answer c Public c Private Grade as of next Fall: Programs covered by this financial aid application (Please select applicable program): c ECE c HYC c Tikvah School of Music & Dance Tuition = $ c JCC Maccabi Games and ArtsFest c Summer Camp Fee = $ Extended Day Care: c ECE c Summer Camp Fee = $ 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 2 Child Last Name: Child First Name: Age: Gender: Birth Date: School: My child considers him/herself, entirely or in part, to be Jewish: c Yes c No c Prefer not to answer c Public c Private Grade as of next Fall: Programs covered by this financial aid application (Please select applicable program): c ECE c HYC c Tikvah School of Music & Dance Tuition = $ c JCC Maccabi Games and ArtsFest c Summer Camp Fee = $ Extended Day Care: c ECE c Summer Camp Fee = $ 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): $ Page 1 of 4

3 Family Information PARENT 1 Gender: c Parent c Stepparent c Guardian c Other PARENT 2 Gender: 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 for the upcoming school year (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 Has your family previously received financial assistance from the JCCSF currently or for the past year? c Yes c No If so, for which family member(s), program(s) and which year(s)? Page 2 of 4

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

5 Statement of Need An explanation of your family s financial circumstances is a mandatory part of this application for financial aid. 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. If more space is needed, attach a separate page with your name at the top. Did you remember to: a fill in ALL of the required information on pages 1 4? Please PRINT the information clearly so it can be easily read. a attach copies of the past two Federal Income Tax Returns (1040 with all Federal schedules only) including W-2 forms and 1099s for all parents/guardians? a attach copies of monthly mortgage statements or copies of receipts for rent checks for two consecutive current months or copies of current rental contract? a fill out the Statement of Need above? a retain a copy of this application for your records? 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/Guardian 1 signature: Date: Parent/Guardian 2 signature: Date: Page 4 of 4