FINANCIAL AID INFORMATION FORM 2008-2009

Junípero Serra High School 451 W. 20th Avenue San Mateo, CA 94403 650-345-0226 www.serrahs.com FINANCIAL AID INFORMATION FORM 2008-2009 Application Deadline: February 8, 2008 Please complete and sign this application and return to: Junípero Serra High School Attn: Business Office 451 W. 20th Avenue San Mateo, CA 94403 You must also complete the Private School Aid Service Form (PSAS) and return it directly to PSAS at the address indicated on their form. Name of Student: _________________________ We are applying for (please check one): _____ * Junípero Serra High School Financial Aid (or) Amount Requesting: ______________________ _____ ** Junípero Serra High School Financial Aid and the Archdiocesan Catholic High School Scholarship Program -1- PART I: Family Information A. Student Information: Last Name First Name Graduating Class _______________________________ _______________________________ _____________________________ _____________________________ 2009 2010 2009 2010 2011 2011 2012 2012 B. Parent/Guardian Information: (list the parents/guardians who live with student including step-parents) Relationship ____ Father ____ Mother ____ Step-father ____ Step-mother ____ Guardian 1) Name_______________________________________________ ___________________________________________________________ Home Address _______________________________________________ Home Phone ________________________________________________ Employer ________________________________________________ Length of Employment ______________________________________ Daytime Phone ______________________________________ City, State Zip_______________________________________ Relationship ____ Father ____ Mother ____ Step-father ____ Step-mother ____ Guardian 2) Name_______________________________________________ ___________________________________________________________ Employer ____________________________________________________ Daytime Phone ______________________________________ Length of Employment ______________________________ C. Additional Parent Information (for parent not residing with student): Relationship ____ Father ____ Mother Relationship _______________________________________ City, State Zip _____________________________________ Name ____________________________________________ Address __________________________________________ Home Phone ______________________________________ Employer ________________________________________________ Length of Employment ______________________________________ Daytime Phone ______________________________________ Is there an agreement specifying a contribution for the education of the above student? If yes, how much per year? ______________% Father ______________% Mother (You may be asked to provide documentation at a later date verifying this) Who will claim the student as a dependent in 2007? ______ Mother ______ Father _____ Yes _____ No -2- PART II: Dependent and Education Expenses Please complete the following for all of your children: Name Age School/College 07-08 Tuition 07-08 Financial Aid Rec’d 07-08 ______________________________ ______________________________ ______________________________ ______________________________ _____ _____ _____ _____ _______________________ _______________________ _______________________ _______________________ ____________ ____________ ____________ ____________ ___________ ___________ ___________ ___________ PART III: Household Income – 2007 Gross Monthly Wages: ______ Father ______ Mother ______Step-Father ______Step-Mother Monthly income from all sources: 2007 Estimate 2008 $ ________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ ______Male Guardian ______Female Guardian $__________________ $ _________________ $ _________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ Business Income from self-employment Income from monthly alimony Income from child support Contribution from others for student’s education (specify _ ______) Workman’s compensation State Disability Social security Other (describe) ____________________________ Trust fund Income Property Total Gross Monthly Income PART IV: Business Income Gross Income Net Profit Annual Salary Total personal expenses paid by business (mortgage, vehicles, insurance, etc) 2007 $ ________________ $ ________________ $ ________________ $ ________________ Estimate 2008 $_________________ $_________________ $_________________ $_________________ -3- PART V: Family Assets/Debt - 2007 A. Banking Information Current total balance in all checking accounts Current total balance in all savings accounts Stocks, bonds, investments Retirement accounts $ ____________________ $ ____________________ $ ____________________ $ ____________________ B. Real Estate Do you rent or own your home _____ rent Year of Purchase ______________________ If owned, what was the purchase price Current loan balance Estimated current market value Monthly mortgage/rent amount (Attach copy of mortgage statement or rental agreement) Property taxes Do you own other real estate ______yes ______no Type of real estate _____________________________ Year of purchase _____________________________ Total purchase price Current loan balance Monthly mortgage amount (Attach copy of mortgage statement or rental agreement) Property taxes $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ _____own C. Vehicles (include leased vehicles) List all family automobiles, trucks, RV’s, boats, etc. Model Make Year Loan Balance $ _________________ $ _________________ $ _________________ $ _________________ Monthly Payment $______________________ $______________________ $______________________ $______________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ D. Other Credit Card Debt (enter the total balance owed on ALL credit cards) Alimony/child support payment $ _____________________ $ _____________________ -4- PART VI: Special Circumstances Please describe any special circumstances that you feel we should take into consideration when reviewing this application. (Attach additional sheet if necessary.) _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ PART VIII: Parent’s Certification and Authorization We declare that all the information we have provided in this application is accurate to the best of our knowledge. We understand that the penalty for reporting false information will nullify our financial aid request. __________________________________________ Father/Step-father (Print Name) __________________________________________ Mother/Step-mother (Print Name) __________________________________________ Guardian/Other (Print Name) _________________________________ Signature Date _________________________________ Signature Date _________________________________ Signature Date ___________ ___________ ___________ Return this form to: Junípero Serra High School Attn: Business Office 451 W. 20th Avenue San Mateo, CA 94403 Application Deadline: February 8, 2008 Be sure to attach copy of mortgage statement or rental agreement -5-