13967 Roscoe Boulevard ● Panorama City, CA 91402 ● P: 818.894.6417 ● F: 818.894.6419 ● www.sgps.org

November 9, 2015

Dear Parents and Guardians,

We hope this letter finds you and your family well. We are reaching out regarding the Catholic

Education Foundation financial aid application. We are attaching to this letter the CEF

application and an addendum that will be used by St. Genevieve High School in the event you

would not qualify for this program.

CEF will be processing applications for 2016-17 Cycle 2 TAP/SOS for St. Genevieve High

School on Friday December 4, 2015. We will have to make appointments for each family to be

interviewed by CEF personnel.

Date: December 4, 2015

Available appointment times are from 1:00 PM to 7:45 PM

With a lunch hour between 4:00 PM - 5:00 PM

We would appreciate it if you could follow the steps below:

Fill out the attached CEF application and return it to the main office as soon as possible.

Make sure to provide all the required paperwork necessary to process your application.

Time is of the essence. Please attend to this matter with high importance.

Please reserve time on December 4, 2015 for CEF interview by calling or emailing Mrs.

Akopyan. The interview will last a minimum of 15 minutes.

If you need any of the attached forms in Spanish contact Mrs. Akopyan.

If you are having difficulties and/or have a question feel free to call Mrs. Akopyan for an

appointment at (818) 894-6417 ext. 104.

Warm regards,

St. Genevieve High School

Information submitted on this application will remain confidential.

STUDENT INFORMATION  

First Name: Middle Name Initial: 

  Last Name:  

Street Address: 

City:  State:          CA  ZIP:  Student Birth Date: ______/______/__________ 

Sex:   Male     Female Grade  entering in Fall 2016:    

School Currently Attending: 

Type of School:    

 Catholic       Public  

 Charter    Home School 

 Other ______________ 

Ethnic Background (Optional):  

 Afro American     Armenian     Asian: _____________(Nationality)      Caucasian/White     Filipino     Hispanic/Latino            

 Pacific Islander     Middle Eastern     Multiple Ethnicities   Native American: ______________(Please List Tribe)   Declined to State    

Religious Background (Optional): 

 

 Roman Catholic     Jewish     Muslim     Mormon     Southern Baptist     Sikh     Hindu     Buddhist       

 Other Christian: _________________     Other: _______________________________     Declined to State     No Religious Affiliation  

HOUSEHOLD INFORMATION 

Parent/Guardian A (Parent or Guardian legally responsible for Student) 

First Name: Last Name: Marital Status:   

 Single        Divorced   Widowed 

 Married    Separated  

 Domestic Partnership 

Relationship w/ Student:      Mother    Father    Grandparent   Step‐Parent     Guardian     Foster Parent     Other _____________________ 

CONTACT INFORMATION   Email:    

Home Phone: (_____) _______‐ ____________  Cell Phone: (_____) _______‐ _____________  

Work Phone: (_____) _______‐ ____________ 

Employment Status:    

 Employed       Self‐Employed  

 Homemaker   Unemployed    

 Retired            Disabled    

 Full‐Time Student 

Occupation:  Employer: 

If self‐employed, type of business: 

  Name of Business:   

Parent/Guardian B (Parent or Guardian residing with Parent/Guardian B) 

First Name: Last Name: Relationship to Parent/Guardian A:    

 Spouse        Relative  

 Ex‐Spouse    Other  

 Domestic Partner 

Relationship w/ Student:      Mother    Father    Grandparent   Step‐Parent     Guardian     Foster Parent     Other _____________________ 

CONTACT INFORMATION   Email:    

Home Phone: (_____) _______‐ ____________  Cell Phone: (_____) _______‐ _____________ 

Work Phone: (_____) _______‐ ____________

Employment Status:    

 Employed       Self‐Employed  

 Homemaker   Unemployed    

 Retired            Disabled    

 Full‐Time Student 

Occupation:  Employer: 

If self‐employed, type of business: 

  Name of Business:   

CEF STAFF  OFFICE USE ONLY 

 

 

 Application Reviewed 

 Data Entered 

 Scanned 

CEF SCHOOL OFFICE USE ONLYSchool Code:   

School Name:   

New Applicant (   ) 

Transfer Applicant (   ) 

Student ID #: 

Cycle 2Application for  

Tuition Assistance 2016/2017 

Page 1 of 3

LIST OF INCOME SOURCES 

PARENT/GUARDIAN INFORMATION 

PARENT/GUARDIAN A  

FIRST NAME:________________________ 

LAST NAME:________________________

PARENT/GUARDIAN B  

FIRST NAME:________________________  

LAST NAME:________________________ 

PRINCIPAL DOCUMENT CHECKLIST 

CEF OFFICE 

USE ONLY

LIST OF ANNUAL SOURCES OF INCOME FOR TAX YEAR 2014 

 Single    Married Filing Joint  

 Married Filed Separately    

 Head of Household   

 Do Not File 

 Single    Married Filing Joint  

 Married Filed Separately    

 Head of Household   

 Do Not File 

 

 

Taxable Income  Please provide the corresponding Supporting Documents 

Employment Income (Form 1040, Line 7)   $  $     

Business/Self‐Employment Income  (Schedule C: Form 1040, Line 12) 

$  $     

Capital Gains (Schedule D: Form 1040, Line 13) 

$  $     

Rental, Partnership, S Corp, Trust Income  (Schedule E: Form 1040, Line 17) 

$  $     

Farm Income (Schedule F: Form 1040, Line 18) 

$  $     

Pension  (Form 1040, Line 16 or Annual Pension Statement) 

$  $     

Unemployment (Form 1040, Line 19)  $  $     

SSI (Social Security)  (Form 1040, Line 20 or SSI Statement) 

$  $     

Cash Income (Notarized Statement of Income)  $  $     

Annual distribution from Investments (Trust funds, CDs, Stocks, IRAs, 401Ks, etc.) 

$  $     

Non‐Taxable Income  Please provide the corresponding Supporting Documents 

Public Housing Assistance/Section 8 (Section 8 Allotment Statement) 

$  $     

CalWORKs: Welfare/TANF (CalWORKS Benefit Amount Statement) 

$  $     

CalFresh: Food Stamps (CalFresh Benefit Amount Statement) 

$  $     

Child Support  (Letter w/ Amount of Support) 

$  $     

Disability (Annual Disability Statement or Supplemental SSI) 

$  $     

Alimony (Letter w/ Amount of Support) 

$  $     

Other Income (Explain) 

$  $     

TOTALS         

 

FAMILY EXPENSES 

Where does this family live? 

 

Monthly Mortgage or Rent: $_____________ 

 Own/Mortgage Home     Rent Home/Apartment     Live in the home of Relative/Friend    Section 8 Housing 

 Federal Housing     Shelter/Temporary Housing     We are Homeless (Streets/Car)      Other  ____________ 

If you are living with friends/family, how much do you contribute monthly?  $____________     

Is your home currently in foreclosure or short sale?   Yes     No 

FAMILY VEHICLES  

Vehicle A: Car Make: _______________    Model: _______________ Year: ________    Monthly Car Payment $____________ # of Months left on car loan: __________ 

Vehicle B: Car Make: _______________    Model: _______________ Year: ________    Monthly Car Payment $____________ # of Months left on car loan: __________ 

Do you use either vehicle for Business?    Vehicle A      Vehicle B 

Page 2 of 3Information on this application will remain confidential.

   

 

 

Catholic Education Foundation (CEF) Policies and Procedures: All CEF Tuition Award Programs are designed to assist students in the Archdiocese of Los Angeles with tuition for enrollment in a Catholic school within the Archdiocese of Los Angeles.  The award partially offsets the cost of tuition in a Catholic school with grants paid directly to the Catholic school after verifying student enrollment in the Fall and Spring of the school year. All information submitted in this application is confidential and used for the purpose of determining eligibility for a CEF Tuition Award and data research.  By signing the application, you grant CEF permission to use the information on this application and to gather additional personal, private information from the attending school concerning the student and your family or to contact you, the applicant, and the attending school to verify the information and/or develop data for educational and research studies, and analysis. You agree to waive and release CEF from all claims in connection with this research.  In addition, you grant CEF permission to request and collect additional data, including test scores related to reading and math, ITBS, PSAT, SAT, AP, ACT test scores. You also grant CEF permission to request and collect tuition rates, GPA, report cards, transcripts, college acceptance, college attendance and data available concerning post secondary education as well as any quantitative and qualitative data on this applicant from such institutions and other resources. CEF will hold this information in confidence and release the name of the applicant or the family name only with your expressed permission.    

The Following CEF Policy Applies to All Applicants Without Exception: 1. Applicant may not receive more than one tuition award from CEF in a given year.  2. CEF does not accept and will not review any applications that are mailed directly to CEF from applicant. 3. CEF Tuition Awards may not be transferred to another student, non‐participating Catholic school, and/or to another diocese. 4. Students awarded a tuition award who are not enrolled and present in a Catholic school during the Fall and/or Spring Verification Process 

will lose his/her tuition award for that school year or the remaining semester, as appropriate. 5. This application must be returned to the participating Catholic school of the Archdiocese of Los Angeles complete with proof of income.  6. Schools must submit all applications to CEF on or before the CEF program deadline.  7. CEF is under no obligation to review or accept any application that is received after the deadline, is incomplete, illegible, unsigned, lacks 

pastor/principal’s recommendation form, lacks the principal/pastor’s signature, does not have adequate proof of income, discrepancies, and/or lacks information that makes it impossible to render a funding decision. 

8. CEF may deny any application due to any CEF Program budget restraints, even after it is submitted by the school. 9. Participating Catholic Schools are under no obligation to submit this application if any of the following criteria have not been met: 

a. Family has refused or not provided adequate, complete, and/or legal proof of income (based on CEF Policy for Proof of Income) or information;  

b. Family income exceeds CEF income guidelines; c. Student does not meet academic requirements to remain enrolled in the school; d. Lack of student and/or family involvement/volunteer service in school or parish; e. Application submitted past any CEF deadline or school’s internal program deadlines. f. Student is a recipient of a award from another Foundation (Rose Hills, Daughters of Charity, etc.) 

 

CEF Policy for Proof of Income (Please submit all applicable documents)  

A. Page 1 of 2014 Federal Income Tax Returns (1040, 1040A or 1040EZ) – Unobstructed View of Page 1 a. Filed Separately 

i. If Applicant and Co‐Applicant file separately, both tax returns are required for the same tax year. b. Dependents 

i. If student is not a dependent on Guardian’s taxes, please provide taxes on which student is a dependent. ii. Please provide the supplemental sheet for dependents if names are not on Page 1 of Form 1040. 

c. Tax Schedules i. Copies of all supporting tax schedules if you have income from any of the following: 

1. Business (Form 1040, Line 12 – Submit Schedule C or C‐EZ: Page 1, 2 & Other Expense Page) 2. Capital Gains (Form 1040, Line 13 – Submit Schedule D) 3. Rental Property, Partnership, Trust (Form 1040, Line 17 – Submit Schedule E: Page 1 & 2) 4. S‐Corporation (Form 1040, Line 17 – Submit Schedule E: Page 2, Form 1120S) 5. Farm Income (Form 1040, Line 18 – Submit Schedule F: Page 1) 

B. Cash Income a. CEF Notarized Statement of Income (Requires a CEF Notarized Statement of Income signed and sealed by a Licensed Notary Public.) 

C. Copies of all supporting documentation for household Non‐Taxable Income:  a. Social Security Income, CalWORKS: Welfare/TANF, Child Support, CalFresh: Food Stamps, Workers Compensation, Disability, Alimony, 

Section 8: Public Housing D. All official documentation to prove income and dependents on “INCOME SOURCES” page of the application. 

_______________________________________________________________________________________________________________________________________________________________

PARENT/GUARDIAN: Your signature below indicates that you have read and understand the CEF Policies & Procedures Page. The information provided on this 

application is true, accurate and complete, and legal proof of income has been provided. You understand that all information on this application will be verified. Any incomplete, missing, false and/or fraudulent information or documentation on this application, missing signatures, refusal to provide adequate/legal proof of income and/or any pertinent information required to process or determine a decision on this application will be cause for automatic denial of a tuition award.    Parent/Guardian A or B Name: ________________________________ Signature: ______________________________________ Date: ___________________  In regards to my students Post‐Secondary Education data, I understand that I and my student have the right to (a) request a copy of any of their Educational Records disclosed to CEF under this consent by contacting CEF and (b) revoke my consent at any time by delivering written notice to CEF at Catholic Education Foundation, 3424 Wilshire Blvd. 3rd Floor, Los Angeles, CA 90010; programs@cefdn.org

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C Copyright © 2014 Roman Catholic Archbishop of Los Angeles, a corporation sole. All rights reserved

PARENT/GUARDIAN RELEASE FOR STUDENT OR MINOR

(NONCOMMERCIAL)

This section to be completed by the Location:

Archdiocese, School or Parish Location (“Location”):

_____________________________________________________________________________

Class/Activity:

_Any Roman Catholic Archdiocese of Los Angeles event or the events of its Subsidiaries____________________________________________________________________________

The above referenced Location intends to use your child’s image, name, voice and/or work for the following noncommercial purposes (describe class/activity, date(s) if applicable):

_____________________________________________________________________________

The following person(s)/entity not connected to the Location will be involved in the class/activity: _________________________________________________________________

_____________________________________________________________________________

This section to be completed by Parent/Guardian:

I ____________________________________________________ am the parent/guardian of

___________________________________________________, a minor. I hereby authorize the

above referenced Location to use the following personal information about my child:

Please initial the applicable boxes

Image/visual likeness: _______ yes _______ no Voice: _______ yes _______ no Name: _______ yes _______ no Work: _______ yes _______ no

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C Copyright © 2014 Roman Catholic Archbishop of Los Angeles, a corporation sole. All rights reserved

I understand and agree that my child’s image, name, voice and/or work (the “Personal Information”) will be used for the particular reasons identified above. I further understand and agree that the Location may use the Personal Information for other noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that the Personal Information of my child may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (the “Materials”).

The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. The Location will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. While the Location will take care to maintain the particular intents and purposes of the photographs or electronic recordings, editing may be necessary to obtain the best results. I release and discharge the Location and its affiliated entities, employees and agents from any liability that may arise out of the making or editing of the photographs or electronic recordings, including but not limited to, distortion, blurring, alteration, optical or auditory illusion or use in composite form. In exchange for the opportunity given to my child by the Location to participate in the class/activity, I hereby agree that neither I, nor my child, will receive monetary compensation, royalties or credit for use of the photographs or electronic recordings by the Location. I understand and agree that the Location shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If the Location intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.

I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Location and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Location. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization.

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C Copyright © 2014 Roman Catholic Archbishop of Los Angeles, a corporation sole. All rights reserved

I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.

Signature: __________________________________________ Date: ___________________

Print Name: ___________________________________________________________________ Relationship to Child: ___________________________________________________________ Address: ______________________________________________________________________ Telephone: ____________________________________________________________________

Name of Child: ________________________________________ Age: ____________________

 

FINANCIAL ELIGIBILITY 

An applicant from a household with total incomes at or below the following levels is financially 

eligible to apply for a CEF tuition award. 

Definition of a Household:  Household size means a group of related or non‐related 

individuals who are living as one economic unit and are sharing living expenses.  Living 

expenses include rent, clothes, food, doctor bills, utilities (electrical, gas, water) and the like. 

 

Definition of a one‐member household:  A household of one means a pupil who is his/her 

sole support.  Institutionalized children are always one‐member households. Foster children are 

one‐member households only if the welfare/placement agency maintains legal responsibility 

for the child. 

The annual gross income amounts indicated below are the family income guidelines for all CEF 

Tuition Award Programs. 

Household Size  Income Eligibility 

1   $          17,596  

2   $          23,815  

3   $          30,035  

4   $          36,254  

5   $          42,473  

6   $          48,692  

7   $          54,911  

8   $          61,131  

Plus 1   $            6,219   

 

The CEF Notarized Statement of Income is to be utilized when taxes are not available or there is unaccounted cash income present. By completing this Notarized Statement of Income, you are swearing that the income and dependents provided on the following page are true.

HOW TO COMPLETE THE CEF NOTARIZED STATEMENT OF INCOME:

1. Fill the form out completely in English/Spanish.

2. Provide the Notary Public with the appropriate documentation to prove income & dependents.

3. Sign the statement in front of a notary public or the

appropriate official The CEF Notarized Statement of Income should be returned along with all other Income Documentation (CalWorks, CalFresh, Disability, etc.) to the Catholic School which you have applied to along with your CEF Application. Please note that not providing all income sources taxes and non-taxable will result in a denial of your application.

CEF Notarized Statement of Income

This Statement is only to be used when taxes are not available or there is unaccounted cash income present in the household.

I/We, _________________________________ & __________________________________ (Name of Parent/Guardian A) (Please Print) (Name of Parent/Guardian B) (Please Print)

hereby swear to be the Guardian(s) of ___________________________________________________ (name of student)(Please Print)

My relationship to the student is _______________________________________________________ (parent, guardian, relative, sibling)

My address is ______________________________________________________________________

Parent(s)/Guardian(s) Name Employer Name # of Hours worked weekly Hourly Rate Weekly Income

Are you receiving any other types of income in the household? (Please check appropriate boxes & provide monthly amount)       Pension: $__________        Unemployment: $___________       Social Security: $___________

      Section 8: $__________        CalWorks: $___________       CalFresh: $___________

       Child Support: $__________        Disability: $___________       Alimony $___________

The following persons are fully dependent upon me for their support. (Please include the student named above)

Dependent Name Relationship to me Age

I swear that the information I have provided above is true and correct and I have provided all possible forms of income in my household.

_____________________/___________________________ __________________________ Signature of Parents/Guardians Date Sworn and subscribed before me this day _________________________________________________ ___________________________________________________________________________________ Signature of Notary Notary Stamp

DUE DATES: New Student- Friday, January 29, 2016 Returning Student- March 15, 2016

ST. GENEVIEVE HIGH SCHOOL

Financial Assistance Packet

2016-2017

STUDENT

LAST NAME___________________________ FIRST NAME_____________________ 16-17 GRADE_____

PARENT/GUARDIAN

NAME(s):_________________________________________________________________________________

CONTACT PHONE NUMBERS: _____________________________________________________________

EMAIL ADDRESS: _______________________________________________________________________

Dear Parents and Guardians,

I would like to take this opportunity to thank you on behalf of St. Genevieve High School faculty and

staff for the opportunity to serve your family. Below is the checklist of all the items necessary to process your

financial aid application. I would appreciate if you would take your time to fill out the application thoroughly.

If you have any questions or concerns please send a note with your application and I will be more than happy to

contact you.

Zara Akopyan

Tuition Advisor

(818) 894-6417 x104

email: zara@sgps.org

APPLICATION CHECKLIST PLEASE INCLUDE COPIES OF ALL NECESSARY DOCUMENTS BEFORE

SUBMITTING YOUR PACKET TO THE MAIN OFFICE.

o $45 Financial Aid Application Fee

o Completed and signed Tuition Assistance Application

o Budget Report (if applying for Principal’s Grant)

o Student Application

o Proof of Income (Single-Member households need to provide legal documentation from the court)

o Copies of Bank Statements for the past 3 months

o Copies of Car Registration Forms for all cars

SERVICE HOUR REQUESTS □ I would like to participate in the Bake Sales (limited positions available). Saturday & Sunday events

□ I would like to participate in Sports Events (limited positions available). Evening events

□ I would like to participate in cooking at home.

□ I would like to donate funds. For every $ 8.00 donated you will earn 1 hour of service.

□ I would like to donate goods. For every $8.00 spent will earn you 1 hour of service.

□ I would like to raise money toward service hours

□ I am available during the day for office help.

Mr. Jose Mejia is the coordinator for all service hours.

He can be reached at (818) 894-6417 x109 or jmejia@sgps.org.

We would like to hear from parents who have any special ideas or needs.

School Office Use Only

New Student ( )

Due date: 01/29/2016

Returning Student ( )

Due date: 03/15/2016

$45 Fee Paid:

Family Income Guidelines

2016-2017

An applicant from a household with total incomes at or below the following levels

is financially eligible for

St. Genevieve High School Financial Assistance.

Household

Size*

Spirit Grant

$1,500

Annual Income

Principal’s Grant

More than $1,500

Annual Income

2

$44,200

$33,000

3

$54,500

$36,280

4

$64,800

$43,560

5

$75,100

$50,840

6

$85,400

$58,120

7

$95,700

$65,400

8

$106,000

$72,680

*Household size is determined by using information on your tax returns.

BUDGET REPORT

(completed only if applicant is applying for the Principal’s Grant)

MONTHLY PAYMENT MONTHLY PAYMENT

HOUSING TRANSPORTATION

Mortgage/Rent $ Car Payment(s) $

Repairs/Maintenance Fees $ Gas $

UTILITIES Car Insurance $

Electricity $ PERSONAL

Gas $ Health Insurance $

Water $ Life Insurance $

Phone/Cable/Internet $ Disability Insurance $

Trash $ Long-Term Care Insurance $

Food $ Child Care $

OTHER (fill in below) Child’s Tuition $

TOTAL MONTHLY EXPENSES $

List all property owned including houses, businesses and other income properties.

Assets (as of the date of this application):

Cash, savings and checking accounts, stocks, bonds, retirement accounts: $

Home equity (renters enter $0): $

FAMILY EXPENSES

Where does the family currently live? (circle one)

Own home Rented Home/Apartment Live in the home of parent/relative/friend

Federal housing Section 8 housing Temporary housing Other

Total Monthly Mortgage/Rent for housing:

How much does the family contribute towards mortgage/rent?

Is your home currently in foreclosure or short sale?

How many cars does your family currently own/lease?

Car Information: Make Model Monthly Payment

1. 2.

Please use the space below to write a brief comment to help us understand your financial need/or special circumstances. _________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

________

POLICY FOR PROOF OF INCOME

Proof of Income

Copies of 2015 Tax Returns or 2014 Tax Returns with 2015 W-2’s

Page 1 and 2 of Tax Returns (1040, 1040A, 1040EZ)

Copies of all supporting tax schedules if you have income from any of following sources:

o Business (Form 1040, line 12 – Submit Schedule C or C-EZ: Page 1, 2 & other expenses)

o Rental Property, Partnership, Trust (form 1040, line 17 – submit schedule E: Page 1 & page 2)

o S Corporation (Form 1040, line 17 – submit schedule E: page 2, form 11205)

If laid off or unemployed please supply employer’s letter/notification of layoff and a copy of unemployment benefits

Cash Income – Statement of income from employer

Non-Taxable Income - Copies of all supporting documentation (Social Security Income, CALWORKS: Welfare/TANF,

Child Support, Calfresh: Food Stamps, Worker Compensation, Disability, Alimony, Section 8: Public Housing)

In order to receive Financial Aid from St. Genevieve High School,

parent/guardian must agree to participate in school wide fundraisers:

All recipients must sell fiesta raffle tickets totaling $300.

Note: the cost of these tickets will be added to your FACTS tuition account.

If granted more than $2,000 you will be asked to participate in additional fundraising activities, including:

Parent casino night (must purchase two tickets for each event)

Each family must sell a total amount of SCRIP that equals the amount of the financial aid received

SERVICE HOURS: Parents agree to complete required service hours or pay $15 for each hour not served.

Spirit Grant =30 Hours Principal’s Grant = Total hours will be determined according to the amount granted

Terms and Conditions: Please review the application instructions and requested documents one final time.

This application and the amount granted by St Genevieve High School to your family should not be discussed with

anyone. If confidentiality is breached, we reserve the right to rescind your tuition assistance.

If using bus service, $1,000 will be added to your FACTS account as Transportation.

Registration fee must be paid.

Your FACTS account must be set up to insure the finalization of your application.

Any student cleared from CEF waitlist who has received $2,000 or more from SGHS financial aid program will not

receive additional funding once CEF waitlist is cleared.

You will be contacted by the tuition office for an appointment for all Principal’s grants.

Once your application is processed and finalized you will receive an email or mail from FACTS Management company

indicating the adjustment(s) made to your account.

Students must attend all school wide major events: Night schools, Special events, Open House, Masses.

Students must comply with the terms of their application. We ask all parents to attend Night Schools.

ST. GENEVIEVE HIGH SCHOOL FINANCIAL AID TERMS AND CONDITIONS

St. Genevieve High School Financial Aid Program is designed to assist students with tuition for enrollment. All information

submitted in this application is confidential and provided for the purposes of determining eligibility for aid from Saint Genevieve

High School. By signing this application, you verify that you understand and agree that all information provided on this form is

true, accurate and complete to the best of your knowledge. You agree that you have provided all requested forms for proof of

income. St. Genevieve High School is under no obligation to review or accept any application that is incomplete, ineligible,

unsigned, has not provided adequate proof of income, or has discrepancies or lack of information that makes it impossible to

render a funding decision. You further agree that your application was submitted before the program deadline of January 29,

2016 for new students and March 15, 2016 for all returning students. Failure to submit your application by the deadline is

grounds for refusal.

Saint Genevieve High School has limited budget for financial aid. We reserve the right to deny your request due to budget

constraints. Your signature below indicates that you have read and understand the terms of this program. The information

provided on this application is true, accurate and complete, and legal proof of income has been provided. We thank you for

giving us the opportunity to serve you family.

Signature of Parent/Guardian A: ________________________________________________________ Date: ______________

Signature of Parent/Guardian B: ________________________________________________________ Date: ______________

Parent Service Hour Intent Form

Dear Parents/Guardians,

I would like to give you an idea how the system works here at St. Genevieve High School for parent service

hours.

We have been fortunate to have parents who have taken the initiative of heading two main activities.

1. The “Bake Sale” witch happens the last Sunday of each month at the Parish

2. The “Snack Bar at Sport Events” at most of our home games

We also have an opportunity for people who cannot come and work. They could donate goods, money towards

their hours.

Below is a possible list of duties you could choose from. Please, mark your intentions and submit this form

with the packet.

I would like to participate in “Bake Sale” (limited positions available) Saturday & Sunday event

I would like to participate in Sports Event (limited positions available) Evening events

I would like to participate in cooking at home for service

I would like to donate “Funds” (for every $ 8.00 donated you will earn 1 hour of service)

I would like to donate “Goods” (for every $8.00 spent will earn you 1 hour of service)

I would like to raise money toward the service hours

I am available during the day for office help

We would like to hear from parents who have any special ideas or contacts.

Student’s Name: ___________________________________Grade_______________

Parent/Guardian Name: _________________________________________________

Day Time Phone number: __________________________Cell:__________________

STUDENT APPLICATION

2016-2017

Financial Assistance

FOR RETURNING STUDENTS

1. Did you receive financial aid from St. Genevieve High School last year?

YES_______ NO_______ If yes, how much did you receive? $_________________

2. Did you attend our high school Open House on Saturday, November 15?

YES_______ NO_______ (if the answer is no, please explain why not)

______________________________________________________________________________

______________________________________________________________________________

3. Thinking back on your previous year(s) at St. Genevieve. Is there one experience that had a

particular impact on your life? Please explain. ________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

FOR ALL STUDENTS

4. What extracurricular activities are you currently involved in?

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________

5. Please list one teacher that would be willing to act as a reference for you:

________________________________________________________________________

6. Tell us about your contribution to your school community last year:

________________________________________________________________________

________________________________________________________________________

7. Please list 5 goals you would like to accomplish in the 2016-2017 school year.

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

8. We appreciate if you could include a thank you letter with your application. Please write the letter

on a separate sheet of paper and attach it to this form.

By signing this application you agree that you will comply with the following terms:

I will maintain at least a 2.0 GPA at the end of each semester.

I agree to participate in one fundraising activity during the school year.

I agree to perform my Christian service hours.

I agree to attend all Night Schools, Special Events, and OPEN HOUSE.

I agree to attend and support my school’s sports teams and performing arts groups.

Signature of Student: _______________________________________ Date: _____________