Financial Aid Eligibility Form

Financial Aid Eligibility Form

JR HAIR ACADEMY
Name*

First NameLast Name
Date of Birth (MM/DD/YYYY):*

MonthDayYear
Date
Social Security Number or ITIN (if applicable)*
000-00-0000
Citizenship / Residency Status (check one):

U.S. CitizenPermanent ResidentDACA/OtherInternational/Other
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Program You’re Applying For (check one):*

1,500 hr Cosmetology1,500 hr Barber
Marital Status:*

SingleMarriedSeparatedDivorcesWidowed
Do you have children or other dependents who receive more than half of their supportfrom you?*

YesNo
Are you currently on active duty or a veteran of the U.S. Armed Forces?*

YesNo
Were you ever in foster care, a ward of the court, or legally emancipated before age 18?

YesNo
Household Size (include yourself):*
Number of Household Members in College (including yourself) for the upcoming year:*
Did you file a federal tax return?*

YesNo
Adjusted Gross Income (AGI):*
Total Wages, Salaries, Tips (W‑2 Box 1 total):*
Other Taxable Income (e.g., interest, unemployment, business income):*
Untaxed Income (e.g., child support received, disability, housing allowance):*
Cash, Savings & Checking Balance (today):*
Investments & Real Estate Equity (exclude primary residence):*
Parent Tax‑Filer Status:

FiledWill fileNon-filler
Parent Adjusted Gross Income:
Parent Wages & Salaries:
Other Parent Taxable Income:
Parent Untaxed Income:
Parent Cash, Savings & Checking Balance:
Parent Investments & Real Estate Equity:
Did your household experience a significant change since the last tax year?*

YesNo
Briefly explain any circumstance you’d like us to consider:
If you do not qualify for grant aid, would you like information on the in‑house payment plan?*

YesNo
Certification & Signature
I certify that the information provided is true and complete to the best of my knowledge. I understand it will be used solely to determine my eligibility for JR Hair Academy financial assistance.

Required Documentation (upload or attach)
‑ Most recent 1040 tax return OR non‑filer statement
‑ W‑2s or recent pay stubs (last two months)
‑ Any documents supporting special circumstances (e.g., layoff notice, medical bills)
Date

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Should be Empty: