Online Flexible Tuition Form

Parent/Guardian #1*
First Last
Home Phone
Cell Phone
Email
Parent/Guardian #2
First Last
Home Phone
Cell Phone
Email
List All Children: Name/Age/Gender
2019 Income and Expenses
Please provide the summary pages of your most recent tax return and answer the following questions fully to provide an accurate and complete picture of your present financial position. The fairness and success of our financial assistance depends on your full and candid response to the following questions.
Salary: Parent/Guardian #1
Salary: Parent/Guardian #2
Interest & dividend income
Other income
Total monthly rent and/or mortgage (less real estate taxes)*
Real Estate taxes paid in 2019
State income taxes paid in 2019
Federal income taxes paid in 2019
Total other large expenses (please specify below)
Please specify other large expenses
Will your tuition be paid from any other source? (if yes, please specify)
Assets & Liabilities
Approximate value of real estate owned and date purchased
Approximate amount of loans against real estate
Total deposited into savings and checking accounts
Total value of stock & bond portfolios and other asset accounts
Total Household debt (please itemize)
Please provide any other information that would help you evaluate your applications for tuition assistance in the box below. Also, please let us know if you anticipate any significant changes in your financial position in the upcoming year.
Please submit your most recent Federal Income Tax Returns to the CCJDS Business Office to be reviewed with your application. Please note, in the box below, when the return will be sent.
Electronic Signature*
- I accept
Please check the box in lieu of a written signature.

2019 Income and Expenses

Assets & Liabilities

VISIT CCJDS

CONTACT US

ABOUT