Education Foundation Application
= Required
Student Information
Student Name
Student ID
Program
Grade
JR
SR
ADULT
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Home School
Home Phone
(###) ###-####
Number of People Living in your Home
Student Lives with (Choose all that apply)
Both Parents
One Parent
Sister(s)
Brother(s)
Foster Parents
Emancipated
Other
Explain Other
Parent/Guardian Information
Parent/Guardian Name(s)
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Home Phone
(###) ###-####
Work Phone
(###) ###-####
Financial Information
Enter dollar amount received
monthly
from the following sources:
Social Security (Parents)
Social Security (Student)
Child Support (Parents)
Child Support (Student)
ADC (Parents)
ADC (Student)
Veterans Benefits (Parents)
Veterans Benefits (Student)
Unemployment (Parents)
Unemployment (Student)
Employment (Parents)
Employment (Student)
Other (Parents)
Other (Student)
Estimate Yearly Income (Parents)
Estimate Yearly Income (Student)
Supporting Parent Peripheral Information
Is student presently employed?
Yes
No
If yes, where?
For how long?
If parent/guardian is presently employed, where?
Does the student own a vehicle?
Yes
No
Is the student currently operating this vehicle?
Yes
No
Does the student receive free lunch?
Yes
No
What financial obligations does the student help with currently?
Additional financial hardships for committee's consideration?
If this is a Special or Emergency request, please explain circumstances?
Are there school related items needed to help you with your education at MVCTC?
What effort has the student or parent made towards fees to date?
Submit
Miami Valley Career Technology Center