TBA Financial Aid Application
Fiscal Year 2023 (July 1, 2022 - June 30, 2023)
Applicant Information
Name
*
First Name
Last Name
Email
*
example@example.com
Preferred Phone Number
*
Please enter a valid phone number.
When did you join Temple Beth Ami?
*
Please list the number and ages of your dependent children, if applicable. Write "n/a" if you have no dependent children.
*
If you have received financial aid from Temple Beth Ami in the past, please indicate approximately how many years has TBA helped you. If not, please write "n/a."
*
Will have you have any children enrolled in Gan Ami for the 2022-2023 school year?
*
Yes
No
Did you have any children enrolled in Gan Ami or Kayitz 2022 summer programs?
*
Yes
No
Your Financial Situation
Annual Household Income - Please use the amount you earn AFTER/EXCLUDING TAXES. Include income from paychecks, social security income, alimony, child support, and any other sources of income, as applicable.
*
Annual Household Expenses - Please include ALL expenses for your household. We strongly encourage you to use the next section to ensure you capture all of your expenses, but it is not required.
*
Detailed Annual Expenses - This section is optional, though it is strongly encouraged to ensure you capture all of your household expenses. Please make sure you fill this section in with ANNUAL COSTS - NOT MONTHLY COSTS - for each applicable line item.
ANNUAL BUDGET
Mortgage/Rent
Home/Renters Insurance
HOA Fees
Home Maintenance (repairs, lawn service, cleaning service, trash removal
Car Payments
Car Maintenance
Car Insurance
Gas for Car(s)
Child Care (including school year and summer programs)
Tuition for Private School and/or College (do not include Machane TBA)
Food (groceries, restaurants)
Additional Insurance (life insurance, long term care, etc.)
Internet/TV
Telephones (landlines and/or mobile)
Pet Expenses (Food and veterinarian)
Utilities (gas, electric, water)
Clothing
Additional loan payments
Property taxes (if not included in mortgage payments)
Medical expenses (deductibles and out of pocket costs)
Children's activities/sports
Entertainment
Gym membership
Vacation
Adult education (non-college)
Miscellaneous expenses
TOTAL EXPENSES (automatically calculates based on all other data entered above)
Calculating Your Expected Financial Contribution to TBA
For Fiscal Year 2023 (July 1, 2022 - June 30, 2023)
Select the appropriate TBA Membership Category for your household.
*
Please Select
Dual Adult Household Age 36+
Single Adult Household Age 36+
Dual Adult Household Age 35-36
Single Adult Household Age 35-36
Dual Adult Household Age 34-35
Single Adult Household Age 34-35
Dual Adult Household Age 33-34
Single Adult Household Age 33-34
Dual Adult Household Age 32-33
Single Adult Household Age 32-33
Dual Adult Household Age 31-32
Single Adult Household Age 31-32
Dual Adult Household Age 30-31
Single Adult Household Age 30-31
Young Professional - Dual Adult Household
Young Professional - Single Adult Household
If applicable, please select the appropriate Machane TBA grade for your child #1.
Please Select
Grade PreK - 2
Grade 3-6
Grade 7
Grade 8-12
If applicable, please select the appropriate Machane TBA grade for your child #2.
Please Select
Grade PreK - 2
Grade 3-6
Grade 7
Grade 8-12
If applicable, please select the appropriate Machane TBA grade for your child #3.
Please Select
Grade PreK - 2
Grade 3-6
Grade 7
Grade 8-12
If applicable, please select the appropriate Machane TBA grade for your child #4.
Please Select
Grade PreK - 2
Grade 3-6
Grade 7
Grade 8-12
Do you have a child who will have a Bar/Bat Mitzvah between July 1, 2022 and June 30, 2023?
*
Please Select
Yes
No
Do you have a child who will be part of the TBA High 2022-2023 Confirmation class?
*
Please Select
Yes
No
Do you have a child who will be part of the TBA High 2022-2023 graduation class?
*
Please Select
Yes
No
Have you fulfilled your commitment to TBA's Building Repair Fund?
*
Please Select
Yes
No
Unsure
THIS FIELD WILL BE AUTOMATICALLY CALCULATED. Based on the information provided above as well as a $125 Security Fee, your expected FY2023 TBA contribution is :
What is your financial aid request?
After considering your expected TBA contribution for the July 1, 2022 - June 30, 2023 fiscal year, how much do you feel able to contribute IN TOTAL FOR THIS FISCAL YEAR?
Please provide an explanation about why you have a demonstrated financial need this year. PLEASE DO NOT USE ANY NAMES IN ORDER TO ENSURE YOUR PRIVACY IS PROTECTED.
Signature
*
Clear
Submit
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