2014 Debate Institute National High School Institute, Northwestern University FINANCIAL AID REQUEST If you are requesting financial aid, you must complete this form. All materials including 2013 tax returns (or conditional 2012 returns) must be received by April 30 (March 15 for early admission) for consideration. Acceptance decisions are not affected by financial aid requests. The basic fee for the Debate Institute is $4,850 for 4 weeks ($3,555 Program Fee, and $1,295 Room and Board). The fee is $6,199 for 7 weeks ($4,298 Program Fee, $1,901 Room/Board). This includes field trips, health service (not insurance), and group events. Transportation to and from the Institute, social activities, and personal expenses are extra. PARENT’S Information Circle all that apply: Parents Married Parents Divorced Single-­‐Parent Household Parents Separated Mother Deceased Father Deceased Check if Custodial ___________________________ APPLICANT’S Information Income (student’s) __________ (From current or anticipated employment) Assets (trust funds, saving accounts, etc.) __________ Mother’s Occupation : Father’s Occupation: ___________________________ 2013 Adjusted Gross Income __________ Income From Child Support __________ Income From Business Operations __________ Number of Exemptions __________ Child Support Expenses __________ Business Expenses __________ Number of Children __________ who are full-­‐time college students during the 2013-­‐2014 academic year 2014 Estimated Adjusted __________ Gross Income Real Estate Home if Owned Other Real Estate APPLICANT’S BUDGET for NHSI Program (How do you propose to finance attending NHSI?) 1.
2.
Present Market Value Unpaid Mortgage 3.
__________________ __________________ __________________ __________________ 4.
4 Weeks $3,555 $1,295 6 Weeks $4,298 $1,901 Total Cost a. Program Fee b. Room and Board c. TOTAL (1A + 1B) $4,850 $6,199 Expected Sources of Financing a. Student’s Contribution $ $ b. Family Contribution $ $ c. Local School $ $ d. Community $ $ e. Other $ $ f. TOTAL (2A through 2E) $ $ Difference $ (Subtract 2F from 1C) $ $ $ FINANCIAL AID REQUESTED A copy of parents’ federal income tax return for 2013 must be submitted. Prior to April 1 5th, 2012 tax documents may be submitted as a temporary conditional placeholder, if tax return projections are similar. NHSI reserves the right to request 2013 tax documents and make any scholarship amendments based on updated information. Students requesting financial aid are strongly encouraged to provide additional information that may be helpful to the financial aid evaluation. Describe any unusual
circumstances that should be known in evaluating your application for financial aid, such as unusual medical problems, age of parents, nonpublic educational
expenses—specify unreimbursed expenses, parent’s impending retirement, etc. Please use a separate sheet of paper. Make sure your name and the division you are
applying to are on the sheet.
I certify that to the best of my knowledge all financial statements submitted by me are accurate.
Parent Signature_____________________________________________
Applicant Signature_____________________________________________
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