FINANCIAL AID REQUEST FORM

Please fill out the Yeshiva Tehilas Shlomo FINANCIAL AID REQUEST FORM and when it is complete, either scan and email it to yeshivats@gmail.com. Or fax it to 610-487-0242 Any questions about this form should be emailed to the above email address.

Please note the following:

• This form including the moral obligation form (which will only apply if a scholarship is awarded) must be completed in its entirety, signed, and emailed to the Yeshiva Tehilas Shlomo Office.
• A complete copy (including all submitted schedules) of the applicant family's most recent Federal tax return (and/or business tax returns if self employed) must accompany this form.
• If an answer is not applicable, please indicate SO by writing n/a.
• If the answer is nothing or none, please state SO.
• The Financial Aid Committee will not consider any request that does not comply with the above stated guidelines.
• The Financial Aid Committee reserves the right to ask for any further information, clarification, and explanation for those matters it deems necessary in order to reach a decision regarding this request.

*Father's occupation *Employers name and address *Years employed at current employer *Expected gross salary for the upcoming 12 months (before taxes) $ *If self employed, how much cash did you draw out of the business in the past 12 months

*Mother's occupation *Employers name and address: Years employed: *Expected gross salary for the upcoming 12 months (before taxes) $ *If self employed, how much cash did you draw out of the business in the past 12 months

Please list sources and annual amounts of other income and/or monies received into the household from sources such as alimony, child support, other businesses, funds from grandparents, trust funds, etc.

*Please list all cars currently owned or leased:

*Do you own or rent your house *Purchase price *Current mortgage balance: *Current monthly mortgage payment: *Year purchas *Amount of original mortgage

*Do you have any other homes, property boats or simmilar assets? If Yes Please include a list, a description and value of all either in America or abroad:

Please list all stocks owned, # of shares, and current market value (attach an additional page if necessary):

*Do you have a maid/housekeeper?

*Please list below information concerning all other dependents who are attending College or Jewish Day Schools (attach an additional page if necessary) Age SchoolFull Tuition this year Amount paid this year

*In which extra-curricular activities/lessons do your children participate? Swimming/Tennis Computers Gymnastics/DancingOther: Sports How much do these activities cost you monthly? $

*Did you take a vacation last year? If yes, to where? Do you plan on taking a vacation this year?

*Does either parent plan on coming to Israel this year to visit your son, if he attends Tehilas Shlomo NoYes If yes, how many family members will be coming including yourself?

*Do you plan on bringing your son home for a visit during the year? No Yes

(Note - barring extenuating circumstances, the Yeshiva believes that receiving a scholarship and spending money on trips to and from Israel are not compatible)

(Note - barring extenuating circumstances, the Yeshiva believes that receiving a scholarship and spending money on trips to and from Israel are not compatible)

Remember: Tuition requests will ONLY be considered if accompanied by your most recent Federal Tax Return.

ALL PARENTS/GUARDIANS IN A HOUSEHOLD MUST SIGN THIS FORM.

I declare, under penalty of perjury, that all of the information in this document is true and accurate.