Printed from HebrewAcademyofTampa.com

Financial Aid Form

Financial Aid Form

 Email

Instructions

Please read all instructions carefully and fill out this form completely to the best of your ability.  We are currently accepting financial aid requests for the coming school year. If you have any questions or concerns you'd like to discuss, please contact the office at 813-963-0706. Please note that only one financial aid application per family is needed. If you have any specific questions regarding the completion of this form, please contact the school office at 813-963-0706 or the school administrator at ha.missgretchen@gmail.com. Copies of your most recent 1040 or 1040A income tax form and W2 form must be sent to the office when you submit this form for financial aid consideration.  Please send those forms to ha.missgretchen@gmail.com or bring the hard copies to the school office.

Person Filling Out Form (if different then Mother or Father)

  First Name

  Last Name

  Relationship to applicant 

 

Parent's (please check if living): Father  Stepfather Mother Stepmother 
Parents Marital Status (please check one): Married  Divorced  Separated 
Please state reasons you feel a scholarship should be granted.
 
Our school's PTA is constantly working to better our school and enrich our children's education.  To that extent, we need volunteers.  If you are requesting a scholarship, we in turn ask that you be a part of our PTA.  Please check the areas in which you will assist:

 Fundraising Food preparation  Chaperones  Chairperson for a fundraising event  Committee member for event  

Public relations/Articles and/or pictures for newspapers or social media posts  

Are there any special talents that you can offer our school?
 

  

Parent Information
Mother


First Name


Last Name 
 

Social Security Number

 Name of Employer and Occupation

Bank Reference


Work Street Address

City

           


Postal / Zip Code

Home Street Address

City
 
Postal / Zip Code

 

Father or Guardian                                                                                

First Name


Last Name 

Social Security Number

 Name of Employer and Occupation

Bank Reference


Work Street Address

City

                


Postal / Zip Code

Home Street Address

City
    
Postal / Zip Code

 

Please list below any other dependents receiving financial support from your family.

Last Name, First Name

Living with family (Yes/No)

Relationship to student/applicant 

Estimate of total annual support from family

Last Name, First Name

Living with family (Yes/No)

Relationship to student/applicant  

Estimate of total annual support from family

Last Name, First Name

Living with family (Yes/No)

Relationship to student/applicant

Estimate of total annual support from family

Please list below all children for which this scholarship will assist and indicate extent of financial support they have received during the past year.  Please list oldest child first.

Name Scholarship aid received last year Estimate of total family support Age/Grade

 

Parents Annual Income and Wages

Salaries and wages and other incomes before taxes

Actual last year (including other incomes earned last year)

Estimated salaries and wages this year

Other income estimated this year (examples: child support, alimony, settlements, etc.)

Mother

Father

Gross Income (add above two numbers together)
Parents Annual Expenses and Incurred Costs
Expenses and other incurred costs (include Mother and Father in these totals) Actual expenses last year Estimated expenses and other incurred costs this year
Housing expenses (mortgage or rent)


Living expenses (utilities, food costs, basic medical costs, basic transportation)
Monthly cost of children's extracurricular activities
Extraordinary expenses (in the box below, please explain any expense listed)  
Total expenses (please add housing, living, extracurricular and extraordinary expenses together and enter into provided box)  

 

Parents Annual Available Income
 

Actual last year (including other incomes earned last year)

 

Estimated expenses and other incurred costs this year 

 

Total available income (subtract your total expenses from your gross income and enter into the provided box)  

 

Please explain in this space any special family circumstances the school should know about in regards to your student aid (for example: divorce or separation arrangements, dependencies of elderly or other family, illness, special housing problems, other children nearing college or in college or private school, etc.)

 

Please use this space to clarify any unusual circumstances that will help the scholarship committee understand your financial situation.

 

Terms of Agreement 
Filling in your full name, current date below and submitting this form constitutes an electronic signature.  You attest that you have checked this form for omissions or errors and that, to the best of your knowledge, the information given is true and correct.


Parent/Guardian Full Name


Date (DD/MM/YYYY format)


Parent/Guardian Full Name 


Date (DD/MM/YYYY format)

Following receipt of a completed application, a personal interview may be requested by either the scholarship committee or the applicant.

 Email