Financial Aid Application

Section 1 - Student Information
Child One - Last Name*
First Name*
M.I.
Child Two - Last Name
First Name
M.I.
Child Three - Last Name
First Name
M.I.
Child One - Grade*
Child Two - Grade
Child Three - Grade
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Student resides with*
- Father and Mother
- Father only
- Mother only
- Father/Stepmother
- Mother/Stepfather
- Guardians
Section 2 - Father/Stepfather Information
Last Name*
First Name*
M.I.
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employer*
Occupation*
Email*
Work Status*
- Employed
- Unemployed
- Self Employed
- Retired
- Student
- Homemaker
- Disabled
Section 3 - Mother/Stepmother Information
Last Name*
First Name*
M.I.
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employer*
Occupation*
Email
Work Status*
- Employed
- Unemployed
- Self Employed
- Retired
- Student
- Homemaker
- Disabled
Section 4 - Divorced, Separated, or Remarried Parents (If Applicable)
Year of Separation
Year of Divorce
When will support for the student end
How much does the other parent plan to contribute to the student’s education for the 2017-18 school year
Is there an agreement specifying this contribution for the student's education?*
- Yes
- No
Section 5 - School Information for Siblings
Name
Age
School or College
Grade
2017-18 Tuition Paid
2018-19 Tuition (est.)
Section 6 - Parents' 2016 Income
Complete all applicable items (include stepparent if parent has remarried).
Adjusted gross income for 2016 (found on IRS Form 1040-line 37) PLEASE INCLUDE (BELOW) EXPLANATION OF ANY SIGNIFICANT CHANGE IN INCOME FOR THE CURRENT YEAR OR FROM THE PRIOR YEAR*
Income tax for 2016 (found on IRS Form 1040-line 63)*
Amount earned from working in 2016. Please answer this question whether or not a tax return was filed for 2016 (found on W-2 Forms)*
Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings) as reported on the W-2 Form. Include untaxed portions of 401(k) and 403(b) plans.*
Child support received for all children*
Welfare benefits such as food stamps, rent subsidy, etc*
Tax exempt interest income (found on IRS Form 1040-line 8b)*
Tax exempt dividend income (found on IRS Form 1040-line 9b)*
Social Security payments that were not taxed*
Workers compensation, disability, unemployment, etc*
Section 7 - Parents' 2016 Expenses
Complete all applicable items (include stepparent if parent has remarried).
Monthly home mortgage or rental payment. If none, please explain*
Monthly home equity payment
Monthly child support and or alimony paid
Average monthly home energy costs (gas, electric, oil, etc.)
Annual amount of medical and dental expenses not covered by insurance
Section 8 - Parents' 2017 Expected Income
Income to be earned from father, stepfather*
Income to be earned from mother, stepmother*
Total of nontaxable income (social security, child support, welfare, etc.) to be received*
Section 9 - Parents' and Students' Assets
(include stepparent if parent has remarried).
Total current balance of parent’s cash, savings, and checking accounts*
Total current balance of student’s cash, savings, and checking accounts*
Current net worth of investments (not including pension/retirement) ~ investment value includes market value of real estate (other than your house), trust funds, money market funds, mutual funds, certificates of deposit, stocks, bonds, other securities, commodities, etc
Current value of balance in pension/retirement account
Current net worth of business (business value minus business debt)~ business value includes the market value of land, buildings, machinery, equipment and inventory
Information for property owned
Home
Purchase price*
Market value*
Amount owed*
Second Residence
Purchase price
Market value
Amount owed
Vacation Property
Purchase price
Market value
Amount owed
Rental Property
Purchase price
Market value
Amount owed
Optional
Please include any additional information which further explains your financial situation
I understand that this is an initial application for aid and that St. Mary's High School may contact me for additional information, including, but not limited to, corraborating documentation, and my application will not be considered complete until all documentation is received. I further understand that submitting this application does not guarantee an offer of admission or a financial aid award. Financial aid, if awarded, may be subject to requirements and limitations at the discretion of St. Mary's High School.
Parent/Guardian Name*
Date*

Please note - Deadline for students is Friday, December 15, 2017.

Financial Aid Application

Section 1 - Student Information

Section 2 - Father/Stepfather Information

Section 3 - Mother/Stepmother Information

Section 4 - Divorced, Separated, or Remarried Parents (If Applicable)

Section 5 - School Information for Siblings

Section 6 - Parents' 2016 Income

Section 7 - Parents' 2016 Expenses

Section 8 - Parents' 2017 Expected Income

Section 9 - Parents' and Students' Assets

Information for property owned

Home

Second Residence

Vacation Property

Rental Property

Optional