tuition assistance application
Calimesa Seventh-day Adventist Church
TUITION ASSISTANCE APPLICATION For Mesa Grande Academy Students (School Year 2017 -2018)
As a church we prioritize Christian Education and recognize the importance of it in the life of our members. Sometimes due t o circumstances beyond our control we are in a position where Christian Education is simply not a financial option on our own. The Calimesa SDA Church has set up a system to partner with the parents and the administration at Mesa Grande Academy to help provide financial assistance for your student(s) during such challenging financial situations. Please carefully fill out this application and return it along with a copy of the first page of your 2016 IRS Form 1040 to the church office by Sabbath, July 29, 2017 at the latest. The Tuition Assistance committee will review your application, and if additional information is needed, a member of the committee will contact you. We will strive to have an answer to you r request for assistance by the middle of August in order to allow for a seamless registration process. Your information will remain confidential to the Tuition Assistance Committee, the Church Finance Committee, and the administration of MGA. If you have any questions please contact Jere Chrispens, Tuition Assistance Coordinator (909 -855-6736 or [email protected]).
APPLICANT INFORMATION Father’s Name:
Mother’s Name:
Guardian (if applicable):
Relationship:
Street: City:
State:
Calimesa SDA Church Member? (Yes/No):
Zip:
Phone: Single Parent? (Yes/No):
Church Membership (if not Calimesa SDA): STUDENT INFORMATION FOR GRADES K-6 Child Name:
(Tuition: $581/mn
Fees: $500 at registration )
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
STUDENT INFORMATION FOR GRADES 7 AND 8 Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
STUDENT INFORMATION FOR GRADES 9-12 Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
COMMITMENT AND SIGNATURE My total commitment per month: I understand that this commitment is for 10 months, and I also understand that I may be required to provide additional financial information before my application for tuition assistance is accepted. Signature: Print Name:
TUITION ASSISTANCE APPLICATION For Mesa Grande Academy Students (School Year 2017 -2018)
As a church we prioritize Christian Education and recognize the importance of it in the life of our members. Sometimes due t o circumstances beyond our control we are in a position where Christian Education is simply not a financial option on our own. The Calimesa SDA Church has set up a system to partner with the parents and the administration at Mesa Grande Academy to help provide financial assistance for your student(s) during such challenging financial situations. Please carefully fill out this application and return it along with a copy of the first page of your 2016 IRS Form 1040 to the church office by Sabbath, July 29, 2017 at the latest. The Tuition Assistance committee will review your application, and if additional information is needed, a member of the committee will contact you. We will strive to have an answer to you r request for assistance by the middle of August in order to allow for a seamless registration process. Your information will remain confidential to the Tuition Assistance Committee, the Church Finance Committee, and the administration of MGA. If you have any questions please contact Jere Chrispens, Tuition Assistance Coordinator (909 -855-6736 or [email protected]).
APPLICANT INFORMATION Father’s Name:
Mother’s Name:
Guardian (if applicable):
Relationship:
Street: City:
State:
Calimesa SDA Church Member? (Yes/No):
Zip:
Phone: Single Parent? (Yes/No):
Church Membership (if not Calimesa SDA): STUDENT INFORMATION FOR GRADES K-6 Child Name:
(Tuition: $581/mn
Fees: $500 at registration )
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
Child Name:
(Tuition: $581/mn
Fees: $500 at registration)
I will pay:
/mn
STUDENT INFORMATION FOR GRADES 7 AND 8 Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
Child Name:
(Tuition: $639/mn
Fees: $525 at registration)
I will pay:
/mn
STUDENT INFORMATION FOR GRADES 9-12 Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
Child Name:
(Tuition: $863/mn
Fees: $550 at registration )
I will pay:
/mn
COMMITMENT AND SIGNATURE My total commitment per month: I understand that this commitment is for 10 months, and I also understand that I may be required to provide additional financial information before my application for tuition assistance is accepted. Signature: Print Name:
