Financial Assistance Application

Financial Assistance Application

Thank you for your interest in The Triangle Nonprofit and Volunteer Leadership Center's Student Programs!
TNVLC strives to make our programs available to all who will benefit from them, regardless of their ability to pay. All financial assistance is granted on a sliding scale based on income and need. All information is kept confidential.

Please have ready the following additional documentation prepared to upload.
1. A copy of your current or previous year’s federal income tax return. If you do not file income taxes, please call 1-800-TAX FORM (1-800-829-1040) for a verification of non-filing or go to IRS.gov for other information.
2. Two most recent paycheck stubs or letters from your employer verifying your employment and stating your annual salary. If you are unemployed, receive social security or a full-time student, please provide a summary of your unemployment benefits, SSI paperwork, or financial aid benefits and student schedule.
Please mark out all social security numbers, tax ID numbers and/or credit card numbers before submitting any paperwork.

Applications must be submitted with all required documentation. Incomplete applications cannot be processed. All financial assistance is distributed on a case-by-case, first come-first-served basis. Please do not register for a program before you submit your financial assistance.

You will receive a determination email from us within 30 days following application submission.

Thank you,

The TNVLC Staff

Student Information
IMPACT CampModel UNCivic Engagement Leadership InstituteCommissioners' AwardMayor's AwardPresident's Award
Student Name*

First NameLast Name
Student Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Student Email Address*
example@example.com
Student Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Birth Date*

MonthDayYear
Date

Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Occupation*
Parent/Guardian Employer*
Parent/Guardian Length of Employment*

Spouse and Dependents Living at Home*

Rows	Name	Employer/School	Birth Date	Gender	Relationship to Parent/Guardian
1
2
3
4
5
6
7

Please share why you are applying for financial assistance:*
Please itemize your gross annual household income.
Salary, Wages, Tips*
Unemployment Compensation*
Social Security Compensation*
Child Support*
Aid for Dependent Children*
Food Stamps*
401(k) Retirement*
Alimony*
School Loan Income*
Housing Allowance*
Other*
= Total Annual Income*

Additional Required Forms
1. Current or previous year’s Federal Tax Return (Form 1040 pages 1 and 2 only or 1040EZ)
2. Copies of your last two paycheck stubs OR a letter from your employer stating your annual salary
3. Copies of any supporting documentation listed in the above annual salary line items (optional)
Current or previous year’s Federal Tax Return (Form 1040 pages 1 and 2 only or 1040EZ)

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Copies of your last two paycheck stubs OR a letter from your employer stating your annual salary

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Copies of any supporting documentation listed in the above annual salary line items (optional)

Cancelof
I do not file a Federal Tax Return based on federal government income guidelines.

Final Certification
I certify that this information is true and complete to the best of my knowledge. I grant permission to the Triangle Nonprofit & Volunteer Leadership Center to verify this information. I agree to notify the TNVLC if my financial status should change.
Signature of Parent/Guardian*

Clear
Date*

MonthDayYear
Date
Signature of Student*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Financial Assistance Application

Student Information

Parent/Guardian Information

Please itemize your gross annual household income.

Additional Required Forms

Final Certification