2017-2018ST. LEO THE GREAT CATHOLIC SCHOOLTUITION ASSISTANCE APPLICATION

THIS APPLICATION MUST BE FILLED OUT COMPLETELY IN ORDER TO BE ELIGIBLE TO APPLY FOR THESE FUNDS

(One Per Family)

APPLICANT

Mother/Guardian’s Name: ______SSN: ______Occupation:______

Employer: ______Work#: ______# of years______# of months______

CO-APPLICANT (if applicable)

Father/Guardian’s Name: ______SSN: ______Occupation:______

Employer: ______Work#:______# of years______# of months______

Home Address: ______City, ______Zip______

Phone #: ______Cell #: ______Email: ______

Please attach a copy of your 2016 Income Tax Return to verify household income

Student’s Name / Current School/Grade / Grade in 2016-2017 / Birth Date / Religion/Church Attending
1.
2.
3.
4.

For which student are you applying for: (circle one) 1234

Did the student receive a financial scholarship last year? Yes ______No ______If yes, which one? ______

Did the student participate in the Federal Free/Reduced Lunch Program in 2016-2017? Yes _____ No_____

Please briefly list any unusual or extenuating circumstances, which might require special consideration in evaluating this application. (If needed, you may attach a separate form)______

Please list what your family does/or will do to support the school and parish. (If needed, you may attach a separate page) ______

______

I promise to keep current on tuition and fee payments to St. Leo the Great Catholic School. I understand that the scholarship payment will be made only if my child is enrolled and I stay current on the tuition and fee payments. Further, I understand that all decisions are final. Finally, I agree to release St. Leo the Great Catholic School from any liability in its efforts to provide this one-year educational award. I agree to allow my child’s picture to be taken in the promotion of this scholarship.

Parent or Guardian’s Signature: ______Date: ______

Relationship to Student: Mother: ______Father:______Guardian: ______

ST. LEO THE GREAT CATHOLIC SCHOOL TUITION ASSISTANCE APPLICATION

INFORMATION AND GUIDELINES

The St. Leo the Great Catholic SchoolTuition Assistance Program, funded through our Annual Gala provides an opportunity for families in need to apply for assistance at St. Leo the Great Catholic Schoolonly.

In order to assist as many families as possible, only one application per family should be submitted. Awards are made on a yearly basis and are not renewable. Even though tuition is based on an 11 month plan, awards are credited beginning in September and ending in May (9 Months). This scholarship is not transferable nor can lump sums be credited.

Any questions regarding the application or the submission process should be directed to the school office.

The Application asks for specific information regarding the household income. Therefore, financial documentation (Copy of 2014 Income Tax Return) must be presented to the school at the time of application. These documents will not be returned to you. They will be attached to the application for income verification and determination to support the award given.

Qualifications

  1. The student(s) must be in grades 5K-8th (3K/4K only if older sibling in 5K-8th)____(initials)
  2. The household must qualify for the Federal Free & Reduced Lunch Program. (see table chart below)____(initials)
  3. The student(s) may not receive Hope for the Future. Only one scholarship per family.____(initials
  4. An official copy of the 2016 Income Tax Return(s) must be submitted with the application for all working members of the student(s) household._____(initials)
  5. The parents must sell their Gala tickets and attend the Annual Scholarship Gala in 2018. Failure to do so will cancel any further assistance from the St. Leo the Great Catholic School Tuition Assistance Program.____(initials)
  6. The parent must be committed to beingactively involved in the school program, participate in required fundraisers, and attend all required events._____(initials)
  7. You must participate in sellingany St. Leo Parish raffle tickets at other parishes. ____(initials)

Find your family’s size and gross income level on the chart below and circle the number of people in your family,

Including all children:

Family Size (circle one) / Annual / Monthly / Bi-Weekly
1 / $22,311 / $1,860 / $859
2 / $30,044 / $2,504 / $1,156
3 / $37,777 / $3,149 / $1,453
4 / $45,510 / $3,793 / $1,751
5 / $53,243 / $4,437 / $2,048
6 / $60,976 / $5,082 / $2,346
7 / $68,709 / $5,726 / $2,643
8 / $76,442 / $6,371 / $2,941
Each additional family member add: / $7,733 / $645 / $298

The Mission of St. Leo the Great Catholic School is to provide a Rigorous, Dual Language, Academic Program rooted in Gospel Values.