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All students applying for financial assistance must first go through the admissions process.

Financial assistance applications will not be reviewed unless a student has been admitted to the School and is registered for the 2015-2016 school year. All amounts granted for financial assistance are applied to the tuition rate only and cannot be applied to Capital Improvement or other fees.

All students must apply to the Step Up for Students Program at www.stepupforstudents.org and provide a copy of the confirmation page with this application.

Financial assistance will be provided based on review and verification of financial information provided on the financial assistance application.

ELIGIBILITY

Students must meet the following requirements in order to be considered for financial assistance:

1. Financial assistance application completed and all required documents submitted to Mrs. Maria Perez in the Tuition Office in room 112.

2. The student must have and maintain a 2.5 grade point average. 3. The student must have and maintain a satisfactory disciplinary record. 4. All fees must be paid in full prior to applying for financial assistance.

APPLICATION DEADLINE

Submit your application as early as possible. The School has allocated a fixed amount of its budget toward providing financial assistance; therefore, these funds are limited and will be provided on a first come, first served basis.

The deadline for submitting the application for the 2015-2016 school year is May 1, 2015.

USING YOUR TAX RETURN

If the student and/or parents need to file a 2014 income tax return with the Internal Revenue Service (IRS), we recommend that you complete it before filling out this application. If you have not completed your return yet, you can submit your application using estimated tax information, and then correct the information after you file your return. However, in order to receive financial assistance, your 2014 tax return should be provided to the School no later than May 1, 2015.

If your family has unusual circumstances that might affect your financial situation (such as loss of employment), complete this form to the extent that you can, then submit it with a letter explaining your financial situation.

Financial Assistance Application 2015-16

Archbishop Edward A. McCarthy High School, “the School”, makes financial assistance available to all students who attend the School regardless of race, color, creed, disability or national origin. The financial assistance program takes the form of hardship assistance. Hardship assistance is determined based on financial need subsequent to the evaluation of the financial assistance application.

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Financial Assistance Application 2015-16

Student Information

Please print all information.

Last Name: ____________________________ First Name: ___________________________ Middle Initial: ______

Mailing Address: ________________________________________________________________ Apt. #: ________ City: _________________________________ State: ____________ Zip Code: ___________

Home Phone: ( ) ______–_________ Cell Phone: ( ) ______–_________

Date of Birth: ____ /____ / ______ (mm/dd/yyyy) Social Security Number: _______ – _____ – _______

Driver’s License Number: ____________________________________ Driver’s License State: ______________ E-mail: _________________________________________________________________

At the beginning of the 2015-2016 school year, what grade level has the student completed?

q

8th grade

q

9th grade

q

10th grade

q

11th grade

How much can your family afford to pay for tuition on a monthly basis? $________._____ Will the student need a parking permit due to

driving his/her car to school?

q

Yes

q

No Vehicle Information Make: _____________________________ Model: _____________________________ Year: ______________________________ Tag #: _____________________________ Current Semester GPA: ______________

School Attended: ___________________________ _______________________________________

For 2014, has the student completed an IRS income tax return?

q

Return completed (provide copy)

q

Will file, but have not completed return

q

Will not file a return

What income tax return did you file or will you file for 2014?

q

IRS 1040

q

IRS 1040A or 1040EZ

q

Foreign Tax Return

q

Tax return with Puerto Rico,

another US Territory or Freely Associated State What was your adjusted gross income for 2014?

$________._____

Enter your income tax amount for 2014. $________._____

Enter your number of exemptions for 2014. $________._____

How much did you earn from working in 2014? $________._____

As of today, what is your total current balance of cash, savings, and checking accounts? $________._____

As of today, what is the net worth of your invest-ments, including real estate? $________._____

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Financial Assistance Application 2015-16

Parent Information

Please print all information.

Marital Status:

q

Married or remarried

q

Single

q

Divorced or separated

q

Widowed Month and year married or remarried, separated, divorced, or widowed: ____ /______

FATHER/STEP-FATHER INFORMATION

Last Name: ____________________________ First Name: ___________________________ Middle Initial: ______

Mailing Address: ________________________________________________________________ Apt. #: ________ City: _________________________________ State: ____________ Zip Code: ___________

Home Phone: ( ) ______–_________ Cell Phone: ( ) ______–_________

Date of Birth: ____ /____ / ______ (mm/dd/yyyy) Social Security Number: _______ – _____ – _______

Driver’s License Number: ____________________________________ Driver’s License State: ______________ E-mail: _________________________________________________________________

Highest Level of Schooling Completed:

q

Middle school/Jr. High

q

High School

q

College or beyond

q

Other For 2014, has the parent completed an IRS

income tax return?

q

Return completed (provide copy)

q

Will file, but have not completed return

q

Will not file a return

What income tax return did you file or will you file for 2014?

q

IRS 1040

q

IRS 1040A or 1040EZ

q

Foreign Tax Return

q

Tax return with Puerto Rico,

another US Territory or Freely Associated State

What was your adjusted gross income for 2014? $________._____

Enter your income tax amount for 2014. $________._____

Enter your number of exemptions for 2014. $________._____

How much did you earn from working in 2014? $________._____

As of today, what is your total current balance of cash, savings, and checking accounts? $________._____

As of today, what is the net worth of your invest-ments, including real estate? $________._____ As of today, are you a dislocated worker?

(laid off, self-employed but not working due to the economy)

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Description: Amount: Balance Owed: MORTGAGE $ ________.____ $ ________.____ MORTGAGE $ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____

Monthly Parish Contributions: Other Monthly Obligations:

Financial Assistance Application 2015-16

FATHER/STEP-FATHER INFORMATION (CONTINUED)

Current Employer

Company Name: ____________________________________________________________ Address: ___________________________________________________________________ City: _________________________________ State: ____________ Zip Code: ___________ E-mail: _____________________________________________________________________ Type of Business: _____________________________________________________________ Gross Annual Salary: $______________ Position: _________________________________

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Financial Assistance Application 2015-16

FATHER/STEP-FATHER INFORMATION (CONTINUED)

Financial Institution

Name: _____________________________________________________________________ Address: ___________________________________________________________________ Type of Account: (check all that apply)

q

Checking

q

Savings

q

Other

Church Information

Church Registered: _____________________________________________________________________ Parish Involvement: _____________________________________________________________________ _____________________________________________________________________________________

Dependents/Obligations

Do you have other children?

q

Yes

q

No Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________

Are there any persons (other than children) for whom you provide?

_______________________________________________________________________________________________ _______________________________________________________________________________________________

Parent Involvement/Volunteering at School: (List Activities)

_______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

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Financial Assistance Application 2015-16

MOTHER/STEP-MOTHER INFORMATION

Last Name: ____________________________ First Name: ___________________________ Middle Initial: ______

Mailing Address: ________________________________________________________________ Apt. #: ________ City: _________________________________ State: ____________ Zip Code: ___________

Home Phone: ( ) ______–_________ Cell Phone: ( ) ______–_________

Date of Birth: ____ /____ / ______ (mm/dd/yyyy) Social Security Number: _______ – _____ – _______

Driver’s License Number: ____________________________________ Driver’s License State: ______________ E-mail: _________________________________________________________________

Highest Level of Schooling Completed:

q

Middle school/Jr. High

q

High School

q

College or beyond

q

Other For 2014, has the parent completed an IRS

income tax return?

q

Return completed (provide copy)

q

Will file, but have not completed return

q

Will not file a return

What income tax return did you file or will you file for 2014?

q

IRS 1040

q

IRS 1040A or 1040EZ

q

Foreign Tax Return

q

Tax return with Puerto Rico,

another US Territory or Freely Associated State

What was your adjusted gross income for 2014? $________._____

Enter your income tax amount for 2014. $________._____

Enter your number of exemptions for 2014. $________._____

How much did you earn from working in 2014? $________._____

As of today, what is your total current balance of cash, savings, and checking accounts? $________._____

As of today, what is the net worth of your invest-ments, including real estate? $________._____ As of today, are you a dislocated worker?

(laid off, self-employed but not working due to the economy)

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MOTHER/STEP-MOTHER INFORMATION (CONTINUED)

Current Employer

Company Name: ____________________________________________________________ Address: ___________________________________________________________________ City: _________________________________ State: ____________ Zip Code: ___________ E-mail: _____________________________________________________________________ Type of Business: _____________________________________________________________ Gross Annual Salary: $______________ Position: _________________________________

Current Monthly Obligations

Financial Assistance Application 2015-16

Description: Amount: Balance Owed:

MORTGAGE

$ ________.____ $ ________.____ MORTGAGE

$ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____ AUTO

Make: ___________________________ Model: _________________ Year: ________ $ ________.____ $ ________.____

Monthly Parish Contributions: Other Monthly Obligations:

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Financial Assistance Application 2015-16

MOTHER/STEP-MOTHER INFORMATION (CONTINUED)

Financial Institution

Name: _____________________________________________________________________ Address: ___________________________________________________________________ Type of Account: (check all that apply)

q

Checking

q

Savings

q

Other

Church Information

Church Registered: _____________________________________________________________________ Parish Involvement: _____________________________________________________________________ _____________________________________________________________________________________

Dependents/Obligations

Do you have other children?

q

Yes

q

No Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________ Name: ___________________________________________________ Age: ___________ School: ___________________________________________________

Are there any persons (other than children) for whom you provide?

_______________________________________________________________________________________________ _______________________________________________________________________________________________

Parent Involvement/Volunteering at School: (List Activities)

_______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

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Financial Assistance Application 2015-16

Parent/Guardian/Student Agreement

By signing this application you agree, if asked, to provide information that will verify the accuracy of your completed form. This information may include U.S. or state income tax forms that you filed or are required to file. Also, you certify that you understand that Archbishop Edward A. McCarthy High School has the authority to verify information reported on this application in any legal manner. You also understand that, if you purposely give false or misleading information, any financial assistance awarded may be revoked, the student may be asked to leave the school, and legal action may be taken at the discretion of the

Principal and Supervising Principal.

WE DECLARE THAT ALL INFORMATION ON THIS APPLICATION IS TRUE TO THE BEST OF OUR KNOWLEDGE AND AUTHORIZE ARCHBISHOP EDWARD A. MCCARTHY HIGH SCHOOL TO VERIFY ITS ACCURACY IN WHATEVER LEGAL MANNER MAY BE NECESSARY.

Student’s Signature: _______________________________________ Date: __________________________

Father’s Signature: ________________________________________ Date: __________________________

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Financial Assistance Application 2015-16

REQUIRED DOCUMENTS

1. Completed Financial Assistance Application for 2015-2016

2. Student’s and Parents’ 2014 Tax Returns

3. 2014 W-2 Forms

4. 2014 – 1099 Forms

5. Bank Statements for the most recent 3 months

6. Pay stubs for the most recent 3 months

7. Letter explaining your financial situation and any unusual circumstances that might

affect your financial situation (i.e., loss of employment). Provide any supporting

documentation (i.e., letter from previous employer or unemployment compensation

claim check stub) which will further allow us to evaluate your situation.

8. Letter from your Pastor or Minister supporting your financial need.

9. After completing this application, make a copy of all pages and documents for your

records, and submit in a sealed envelope to Mrs. Maria Perez in the Tuition Office,

room 112.

All forms can be downloaded at: www.mccarthyhigh.org

Archbishop Edward A. McCarthy High School, 5451 South Flamingo Road, Southwest Ranches, FL 33330 www.mccarthyhigh.org Questions regarding financial assistance application procedures may be directed to:

Mrs. Maria Perez Tuition

954.640.5902

References

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