For Office Use only:
Date received _______________________
GPA ________ SAT ________ ACT ______
EFC ________ M#____________________
Housing: (circle one) ON OFF
2010-2011 Student Aid Profile
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Student’s Legal Name: _______________________________________________________________
Home address: ____________________________________________________________________
City: _____________________ State: _____ Zip: __________ Phone: _______________________
Email: _________________________ Will you receive a scholarship from your church? ___ Yes ___ No
If yes, name & phone number of church___________________________________________________
Do you have a parent who is a full-time Nazarene minister? ___ Yes ___ No
Will you have a sibling attending MNU? If yes, please list name: _______________________________
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Household and Income Information
(Please use 2008 Income information from your 1040 and W-2s)
*All blanks must be satisfied in order to process information*
Parent/
Spouse
Student
1. Total number of family members during 2010/2011 (include student)
__________
2. How many in the question above will be college students in
2010/2011? (exclude parents)
__________
3. Parent/Student Marital Status
__________ __________
4. State of Legal Residence
__________
__________
5. Date you became a legal resident of the state above
__________
__________
6. Date of birth of older parent & student
__________
__________
7. Adjusted gross income (1040-line 37; 1040A-line 21; 1040EZ –line 4)
__________
__________
8. Federal tax paid (1040-line 56; 1040A–line 35; 1040EZ-line 11)
__________
__________
9. Income earned from work (Father and/or step-father)
__________
10. Income earned from work (Mother and/or step-mother)
__________
11. Income earned from work (student/spouse if married)
12. Child support received for all children
__________
__________
__________
13. Deductible IRA or Keogh payments (1040-line 28 & line 32; 1040A-line 17)
__________
__________
14. Payments to tax-deferred pension plans (see W-2, Box 12a-12d; Codes D-H & S)
___________
___________
15. Housing, food & living allowances for clergy, military
__________
__________
__________
__________
__________
18. Net worth of real estate and investments (Do NOT include
retirement accounts or home value)
__________
__________
19. Net worth of business (if more than 100 employees)
__________
__________
16. Untaxed portions of pensions from IRS
(1040 lines 16a-16b, 1040A lines 5a-5b, EXCLUDED ROLLOVERS)
17. As of today, total balance of cash, checking and saving accounts
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Please return this completed form to:
STUDENT AID PROFILE SUBMISSION
MidAmerica Nazarene University
DEADLINE IS December 31, 2009
Office of Admissions
2030 E. College Way
**Reminder: Please answer all of
Olathe, KS 66062
the above questions. We cannot
1.800.800.8887 ext. 3298
process your application if any are
Fax: 913.971.3481
left blank.**
Student Aid Profile
2010-2011 Academic Year
INSTRUCTIONS: This Student Aid Profile is designed for U.S. citizens or permanent residents. If you do not meet either
criteria, please call us for more information. The information on this form will be used to estimate your eligibility for student
financial aid for the 2010-2011 school year. We have made it as brief and easy as possible. The Free Application for Federal
Student Aid (FAFSA) that you will eventually complete collects a great deal more information with much more detailed
instructions. Your official financial aid award(s) will be based on your 2010-2011 FAFSA and your 2009 tax return
information.
After completing this form, please fax it to 913-971-3481 or mail it to:
MidAmerica Nazarene University, Admissions Office, 2030 E. College Way, Olathe, KS 66062
Divorced, Separated, or Remarried Parents
The federal government has established detailed rules about whose resources must be reported in cases of divorce, separation,
and remarriage. In brief, students must report the marital status, income, assets, and other information of the parent who has
custody plus that parent's current spouse (stepparent), if any. If you have questions about whose information to report, please
call us for advice.
Foreign Tax Filers
If your parents filed a tax return in a foreign country, convert all figures in questions 7 through 18 to U.S. dollars, using the
exchange rate that is in effect today.
1.
Number of family members: Enter the number of people your parents will support between July 1, 2010 and
June 30, 2011. Include yourself, your parents, and other children who will get more than half of their support from
your parents. If your parents support others, call us to see if they should be included.
2.
Number in college: Of the children included in question 1, how many will be enrolled at least half-time in college
degree or certificate programs between July 1, 2010 and June 30, 2011? Be sure to include yourself. If your parents
are in college, do not include them.
3.
Marital Status: List the marital status of the custodial parent and the marital status of the student.
7&8. 2008 AGI and Tax Paid – Parents should refer to their 2008 Federal Income Tax Return to find their Adjusted Gross
Income and Taxes Paid.
9-11. 2008 Income earned from work: Report the amounts your parents earned from working in 2008. Add up earnings
from your parents' (or student/spouse) W-2 forms and other earnings from work that are not reported on W-2 forms.
12. Include any child support received in 2008.
13. Include any tax-deferred IRA, Keogh, 401(k) and 403(b) plan payments made in 2008.
14. Include payments made to tax deferred pension and savings plans (paid directly or withheld from earnings).
15. Include any housing, food or living allowances that you received in 2008 due to military or clergy status.
18. Real estate and investments: Include real estate (other than your home), trust funds, money market funds, mutual
funds, certificates of deposit, stocks, bonds, other securities, installment and land sale contracts, the value of prepaid
tuition plans owned by the parents, etc., minus any debt that is related to these assets. Do not include the value of life
insurance and retirement plans (pension funds, annuities, IRAs, Keogh plans).
19. Net Worth of Business or Farm: Net Worth means current value minus debt. Do not include the value of a small
business that has 100 or fewer full-time or full-time equivalent employees.
Please make a copy of the completed Student Aid Profile for your records.