NPCS Tuition Assistance Application
for School Year 2024/2025
APPLICATION DEADLINE IS MAY 24, 2024
Father/Guardian
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Employer and Occupation:
Parish Registered In:
Frequency of Mass Attendance:
Mother/Guardian
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Employer and Occupation:
Parish Registered In:
Frequency of Mass Attendance:
Parental Status
Both live at home
Divorced
Separated
Father Deceased
Mother Deceased
Enrolling Student(s) Live With:
Person Responsible for Tuition:
Student #1
First Name
Last Name
Gender
Male
Female
Age
Current School and Grade
Student #2
First Name
Last Name
Gender
Male
Female
Age
Current School and Grade
Student #3
First Name
Last Name
Gender
Male
Female
Age
Current School and Grade
Student #4
First Name
Last Name
Gender
Male
Female
Age
Current School and Grade
Please list all other dependent children (not including applicants:)
Name, Gender, Age, Current School and Grade
Financial Information
Total Number in Household
2023 Adjusted Gross Income
2023 Food Stamp Allocation
2023 ADC/AFDC Income
2023 Social Security Income
2023 Child Support Received
2023 Rent Subsidy Received
TOTAL INCOME
2023 Child Support Paid
2023 Donation Amount to Parish
2023 Donation Amount to NPCS Endowment
2023 Donation Amount to Other Charities
Please provide any additional information that would be helpful (recent loss of employment, uninsured medical expenses, etc...)
Please Confirm that you will submit the following document in addition to this application:
Copy of most recently filed 1040 Tax Return (attach below, e-mail to k.dodson@npcschools.org, or paper copy to the St. Pat's High School main office)
1040 Tax Return
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Please Confirm that you will submit the following document in addition to this application:
Copy of current pay stubs (attach below, e-mail to k.dodson@npcschools.org, or paper copy to the St. Pat's High School main office)
Pay Stub
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Please indicate the Tuition Assistance Funds for which you would like to be considered. *Select all that you believe apply to your family.
Joseph & Mary Sedlacek Memorial Fund (grades 1-12, need-based)
Henley Memorial Fund (grades 1-12, need-based, C average, community service)
Marilyn Brownell Hirsch Fund (grades 7-12, need-based)
Phil & Helen Breen Memorial Fund (grades 7-12, faith and school involvement)
John Kirchner Memorial Fund (grades 9-12, need-based, school involvement and community service)
St. Pat's Growth Fund (grades 1-12, need-based, school involvement and community service)
Jerome & Betty Steffes Tuition Assistance Fund (grades 1-12, need-based, commitment to school system)
Volunteer Commitment
Please indicate the areas in which you are willing to serve:
Volunteer service in school, office, or church
Volunteer service for school activities (gate, concessions, clean-up)
Volunteer service for Endowment activities and events
Describe your student(s) involvement in extra-curricular activities and your family's involvement in activities at the North Platte Catholic Schools:
Describe your commitment to your Catholic faith and involvement in your Parish:
Explain how an education at NPCS will benefit your student(s) and your family:
I certify that all of the information provided on this application is true and complete to the best of my knowledge.
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