HLV Financial Aid Application

Financial Aid Application Form
To be completed by Parent/Guardian

Please fill out the corresponding sections that best describe your situation.
Student Name

First NameLast Name
Parent/Guardian #1 Name

First NameLast Name
Parent/Guardian #2 Name

First NameLast Name
Parent/Guardian #1 Email
example@example.com
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #1 Tel
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian #2 Tel
Please enter a valid phone number.Format: (000) 000-0000.
Address #1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Address #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please make a brief statement describing why you seek financial assistance and indicate an affordable maximum amount.
What is your occupation/job title?
What is your spouse's occupation/job title?
Number of Dependents
Adjusted Gross Income
Total Income
List Special Circumstances (if any)
How much do you feel you can contribute to your child's camp tuition?
Please upload the first page of your latest Income Tax Form 1040 for the past two years either for the family or for all financially involved parents or guardians.

Cancelof
I affirm that the information in this form is true and accurate according to my knowledge.
Guardian/Parent Signature
Date

DayMonthYear
Should be Empty:

Financial Aid Application Form