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Student's Name:
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Email:
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CCC Admissions Counselor:
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Address:
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City/State/Zip:
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Telephone:
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Year of H.S. Graduation:
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Major:
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Name of High School:
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Name of Church:
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H.S. / College GPA:
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ACT / SAT Score:
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# in Household:
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(Include yourself, your parents, your brothers
and
sisters and anybody else living in the household receiving 1/2 of
his/her
support from your parents.) |
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# in College:
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(Do not include your parents. Include
yourself and anybody else in the household attending college at least
half time during
the 2008-2009 school year.) |
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Is this a single parent household?
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Yes No |
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Note: Please type "0.00" or "None" for
amounts equaling zero. |
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Does your father work?
2007 Adjusted Gross Income:
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Yes No
$ |
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Does your mother work?
2007 Adjusted Gross Income:
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Yes No
$ |
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Have you filed the 2008-2009 FAFSA?
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Yes No |
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Do your parents receive housing as a part of
their
salary?
Value of housing received:
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Yes No
$
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Do you plan to participate in a varsity
sport at
Central?
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Yes No
Sport(s): |
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Student's estimated income from work
for 2007:
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Savings:
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Parent(s) estimated income from work
for 2007:
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Savings:
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Other 2007 Untaxed Income:
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(401(k) & 403(b) Pension Plans, Social
Security, Child Support received, EIC, Welfare Benefits, Rental Income,
Etc.) |
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Parent(s) Net Assets from investments, business, or farm:
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(Excluding personal home and farm)
(Net Assets = Value minus debt) |
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Estimated outside aid from relative, church, club, school, or
scholarship:
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