2025-26 Financial Assistance Application

2025-26 FINANCIAL ASSISTANCE APPLICATION

For Youth & Family Programs occurring between January 1, 2025 and August 31, 2026

Thank you for your interest in the Stroum Jewish Community Center’s (SJCC) Youth & Family Programs. Our goal is to ensure that as many children and families as possible are given the opportunity to attend and participate in programs at the J.

To apply for Financial Assistance you must have no outstanding obligations with SJCC and have an income at or below the levels on the Annual Household Income Chart (below). If you believe you qualify, follow the instructions below to complete your application. All the sections must be completed to be considered for tuition assistance.

APPLICATION INSTRUCTIONS

Household Income: Last Year Actual
1. If you are applying before April 15, 2025 Use the information from your 2023 Federal Income Tax Return to complete the Last Year Actual column.
2. If you are applying after April 15, 2025 Use the information from your 2024 Federal Income Tax Return to complete the Last Year Actual column. If your 2024 Federal Income Tax Return is not available in time prior to the submission deadline, you may use estimates and submit your 2024 Return once it is available; any award is conditional upon review and verification of your 2024 Federal Income Tax Return.
Household Income: This Year Estimate column, fill in the boxes with your estimates for the entire twelve months of 2025.
Household Size: Enter the total number of people in your household (adults and children); you will be asked to provide details for each member of your household in Section III below.

ELIGIBILITY

Initial eligibility is determined by the Percentage of Eligible Income, calculated based on your inputs in Section I (below).

If the Percentage of Eligible Income is less than or equal to 1.0, you are eligible to apply for Tuition Assistance.
If the Percentage of Eligible Income is greater than 1.0, you do not meet the initial eligibility criteria. However, you are still encouraged to complete and submit an application for consideration.

Annual Household Income Chart per 2024 King County HUD (Represents 80% of Median income):

2 Persons	3 Persons	4 Persons	5 Persons	6 Persons	7 Persons	8 Persons
$88,800	$99,900	$110,950	$119,850	$128,750	$137,600	$146,500

I. Determining Eligibility

Complete thesection below, by following the steps below this section, to determine yourfamily’s initial eligibility.

Household Income*

	Last Year Actual	This Year Estimate
Wages, Salaries, tips , etc.
Addback Retirement Contributions
Interest
Dividends
IRA, pensions, annuities
Social security benefits
State & local tax refunds
Alimony received
Business income
Capital gain or loss
Other gain or loss
Rental real estate, royalties, partnerships, etc.
Unemployment compensation
Other income

Do you have a Child Support Agreement (last year or this year)?*

YesNo

Child Support

	Last Year Actual	This Year Estimate
Child Support (Include copy of Child Support Agreement)

Upload Child Support Agreement

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Last Year Total
This Year Total
Median Income
Household Size*
Include all adults and children living in your household
Eligible Income
% of Eligible Income
If you did not file a 2024 Federal Income Tax Return or have any special circumstances in your income situation please explain in the box below. Special circumstances can include: job loss, adult going back to school, elder care, etc.
You must provide supporting documentation such as divorce decree, alimony agreement, or child support agreement.

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III. APPLY FOR TUITION ASSISTANCE

If you are initially eligible to apply for tuition assistance per Section I above, complete the sections below. Fill in the sections as completely and accurately as possible. Applications will not be processed if information and/or documentation is missing or incomplete.
Family Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Which program are you applying for Financial Assistance?*
Other Program - Please Specify

Summer J Camp

	Child/Participant's Name	Planned Number of Weeks
1
2
3
4

Total Number of Weeks

List Household Members*

	Full Name	Age (as of Jan 1 2025)	Relationship to Applicant
1
2
3
4
5
6
7
8

Total Household Members
Total Household Members must match the number provided in Section I: Determining Eligibility.

EMPLOYMENT

Provide current employer references for all applicants, including 2 most recent pay stubs).

Reference 1
Employer*
Name of Applicant*
Job Title*
Length of Employment*
Supervisor Name*
Supervisor Phone*
File Upload: Last 2 Pay Stubs*

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Reference 2
Employer
Name of Applicant
Job Title
Length of Employment
Supervisor Name
Supervisor Phone
File Upload: Last 2 Pay Stubs

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Reference 3
Employer
Name of Applicant
Job Title
Length of Employment
Supervisor Name
Supervisor Phone
File Upload: Last 2 Pay Stubs

Cancelof

Reference 4
Employer
Name of Applicant
Job Title
Length of Employment
Supervisor Name
Supervisor Phone
File Upload: Last 2 Pay Stubs

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- Applications received by March 1, will be notified by March 15
- Applications received by April 1, will be notified by April 15
- After April 1, applications received by the 1st of the mont will be notified by the 15th of the same month.
You have 15 days from notification to provide written acceptance of your financial aid to the SJCC Scholarship Manager. After 15 days, unaccepted financial aid applications will be cancelled.

ALL FINANCIAL INFORMATION IS KEPT STRICTLY CONFIDENTIAL

Limited funds are available for financial assistance. The SJCC prioritizes eligible requests according to the needs of each household and considers extenuating circumstances as well as income and expense.
CERTIFICATION

I/we attest the information provided herein is accurate to the best of my/our knowledge and is based on my/our current financial status. I/we understand SJCC reserves the right to re-evaluate any assistance granted during the period of a tuition assistance award. I/we will notify SJCC of any change in my/our financial status. I/we have included copies of all requested documents.
Applicant Name*
Date*

MonthDayYear
Date
Applicant Signature*

Clear
Applicant Name
Date

MonthDayYear
Date
Applicant Signature

Clear
Should be Empty:

2025-26 FINANCIAL ASSISTANCE APPLICATION

I. Determining Eligibility

III. APPLY FOR TUITION ASSISTANCE

EMPLOYMENT

CERTIFICATION