Walter S. and Evan C. Jones Foundation

2501 W. 18th Ave., Suite D

Emporia, KS 66801

(P) 620-342-1714 (F) 620-342-4701

Application Deadline: Fall Enrollment – July 16, 2012

To be considered, a student must be aUS Citizen and current resident of Coffey, Lyon, or Osage County. A current resident is defined as someone who has resided continuously in one of the three counties for a minimum of one year immediately prior to attending a post-secondary institution. A student who moves to one of the three counties and attends a post-secondary institution prior to establishing residency is not eligible to apply.

Before applying, the student must complete the Free Application for Federal Student Aid (FAFSA), apply and be accepted to an accredited post-secondaryinstitution and plan to be or enrolled as degree seeking in a minimum of 12 credit hours per semester.

In addition to our application, these documents are required:

  1. Parents’Previous Year’s Federal Tax Return (if dependent)– If you file IRS 1040 or 1040A, pages 1-2 are required. If there is an amount listed on Line 17, include Schedule E. If you file IRS 1040EZ, page 1 is required.
  1. Previous Year’s Federal Tax Return (if independent) – If you file IRS 1040 or 1040A, pages 1-2 are required. If there is an amount listed on Line 17, include Schedule E. If you file IRS 1040EZ, page 1 is required.
  1. FinalStudent Aid Report (SAR)–We require this report beprinted in .htmlformat only. This is NOT a copy of your FASFA application.
  1. Financial Aid Award Letter–Please submit your most current copy.
  1. High School Transcript – Please submit if you are a high school senior or first-time applicant who has not attended a post-secondary institution after high school.
  1. Official Transcript (submitted in sealed envelope from the institution) –If you are a first time applicant and have attended a post-secondary institution prior to this application.

The student is responsible for providing all required documentation. You will be contacted only once for outstanding documents. Should you not respond, your application will be voided.

All completed applications are reviewed by the Board of Trustees. The Jones Foundation will notify applicants of the Board’s decision. The Jones Foundation requests that you do not phone the office for the Board’s decision.

Jones Foundation Application for Undergraduate Education Grant

General Information:

Name: First______Middle______Last______

Social Security #:______School Email Address: ______

Home Phone:______Cell Phone:______Work Phone:______

County of Residence (circle one): CoffeyLyonOsage Number of Years:______

1. Name & Address of the school you will attend:______

______

2. For what Course of Study have you been accepted?______

3. When completing the FAFSA, did your parent’s provide their information? Yes___ No___ If yes, your parents are to complete the section below. If no, please provide your information.

Additional Information:

List the Name and Age of All Dependent Children living in the home:

(If none, please state none.)

Name of Child / Age

1. If your children are not claimed on your tax return, who claimed them, and why?______

______

2. Will this year’s income be different than last year? If so, please explain.______

______

3. Do you plan to visit with the financial Aid Department regarding your financial situation? Yes__ No__

Everything that has been included above is correct to the best of my knowledge. I understand that the Foundation will retain this application whether or not it is approved. I hereby authorize The Jones Foundation to verify this information given, if necessary.

______

Student Signature DateParent Signature Date