financial aid worksheet

Fill out this worksheet if you're interested in receiving an estimated financial aid package. All fields are required. Please enter NONE or 0 where appropriate.

Student's Name:
Email:
CCC Admissions Counselor:
Address:
City/State/Zip:
Telephone:
Year of H.S. Graduation:
Major:
Name of High School:
Name of Church:
H.S. / College GPA:
ACT / SAT Score:
# in Household:
(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.)
# in College:
(Do not include your parents.  Include yourself and anybody else in the household attending college at least half time during the 2012-2013 school year.)
Is this a single parent household?
 Yes  No

Note: Please type "0.00" or "None" for amounts equaling zero.
Does your father work?
2011 Income from work:
 Yes  No
$
Does your mother work?
2011 Income from work:
 Yes  No
$
Have you filed the 2012-2013 FAFSA?
 Yes  No
Do your parents receive housing as a part of their salary?
Value of housing received:
 Yes  No

$

Do you plan to participate in a varsity sport at Central?
 Yes  No
Sport(s):
Student's estimated income from work or Adjusted Gross Income for 2011:
Savings:
Parent(s)Adjusted Gross Income for 2011:
Savings:
 

Other 2011 Untaxed Income:

(401(k) & 403(b) Pension Plans, Child Support received, Unemployment, Rental Income, Etc.)
 

Parent(s) Net Assets from investments, business, or farm:

(Excluding personal home and farm)
(Net Assets = Value minus debt)
 

Estimated outside aid from relative, church, club, school, or scholarship:
Verify the Text:

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