Financial Aid Estimate Form For early decision candidates

Please complete this form if you would like an early estimate of your eligibility for financial aid. Submit the most recent copies of your parent and student federal income tax returns including all schedules and W-2 forms by mail or fax. Please submit to: Moravian College, Office of Admissions, 1200 Main Street, Bethlehem, Pennsylvania 18018 (fax 610/625.7930). Additional information on how to complete this form can be found at http://www.moravian.edu/aidglossary/.

Use this form if you are a United States citizen who is a dependent of your parents. If you are not a U.S. citizen, are a veteran of the armed forces, consider yourself to be independent of parental support, or have any questions, please contact the Office of Admissions by phone (800/441.3191 or 610/861.1320) or email admissions@moravian.edu.

Please submit this form electronically. See Step Seven.

* designates required fields
STEP ONE: STUDENT INFORMATION
Student's Name  
1 Last *
First *
Middle
Permanent Address  
2 Street *
Apartment Number:
City *
Country of Citizenship (if not US)
State *
ZIP Code *
E-mail
Other Information  
3 Date of Birth (mm-dd-yyyy) * - -
4 Permanent Phone *
5 Cell Phone
High School Information
6 High School Name *
  City *
  State *
  Class Rank * Total in Class *
  GPA * GPA GPA Scale *
  Have you been inducted into the National
Honor Society (NHS)? *
Yes, I am member of NHS
No, I am not a member of NHS
  SAT Scores *

Critical Reading
Math
Writing

College Residence
7 Do you plan to live on campus? *

Yes
No
If not, where?

8 Are you a first-generation college student?
(You are considered a first-generation student if neither of your parents graduated from college with an associate or baccalaureate degree.) *
Yes No
 
STEP TWO: PARENT INFORMATION
9 What is your parents' marital status as of today?
(select one) *

Married/Remarried
Single
Divorced
Separated
Widowed

10

Give information about your family. Only five family members are shown here but you will be able to enter additional family members in STEP SIX. (Glossary help)

Student Name (Family Member 1)
Enrollment Fall '11
Enrollment Spring '12

 

Full Name of Family Member 2
Age
Relationship to student
Name of College if Enrolled During 2011-12
Year in School
Enrollment Fall '11
Enrollment Spring '12

 

Full Name of Family Member 3
Age
Relationship to student
Name of College if Enrolled During 2011-12
Year in School
Enrollment Fall '11
Enrollment Spring '12

 

Full Name of Family Member 4
Age
Relationship to student
Name of College if Enrolled During 2011-12
Year in School
Enrollment Fall '11
Enrollment Spring '12

 

Full Name of Family Member 5
Age
Relationship to student
Name of College if Enrolled During 2011-12
Year in School
Enrollment Fall '11
Enrollment Spring '12

-
-
-

 

 

 

 

 
STEP THREE: STUDENT AND PARENT INCOME
For Step THREE, complete the questions with gross taxed and untaxed income you and your family expect to receive from January 1, 2010 until December 31, 2010. Estimate amounts as best you can. The more accurate your estimates, the more accurate the Financial Aid Office can estimate your eligibility. You may refer to your 2009 tax forms to aid in your 2010 estimates. For questions 11-26, if the answer is zero or the question does not apply, enter 0.
 

 

Student Parent(s)
11

What income tax return will you file for 2010? *

 

IRS 1040
IRS 1040A
IRS 1040EZ
Not Filing

IRS 1040
IRS 1040A
IRS 1040EZ
Not Filing
12

Total number of exemptions for 2010. *

 

13

Adjusted gross income for 2010*

$ $
14

U.S. income tax paid for 2010 *

$ $
15

Income earned from work for 2010*

Answer this question whether or not you file a tax return.

Student
$

 

Father
$

Mother
$

16

Untaxed Social Security benefits for 2010
(for parents and all household members) *

$ $
17 Payments to tax-deferred pension or other retirement or savings plans for 2010 (Glossary help) * $ $
18

Child support received for all children *

$ $
19 Earned income credits (IRS Form 1040, line 64a) or additional child tax credit (IRS Form 1040, line 65) * $ $
20

Other untaxed income such as disability, untaxed portions of IRA distributions and pensions, or welfare benefits *

$ $
21

EXPENSE: Child support paid for all children *

  $
 
STEP FOUR: STUDENT AND PARENT ASSETS
    Student Parent(s)
22

As of today, what is your total current balance of cash, savings, and checking accounts? *

Do not include student financial aid.

$ $
23

As of today, what is the net worth of your home /
primary residence
? *

(Net worth = value minus debt)

$ $
24 As of today, what is the net worth of your current investments? (excluding retirement accounts) * $ $
25

As of today, what is the net worth of other real estate? *

Do not include permanent home / primary residence.

$ $
26

As of today, what is the net worth of your current businesses and/or investment farms? *

Do not include a farm that you live on and operate.

$ $
27 Does your business employ more than 100 people? * yes
no
n/a
 
STEP FIVE: OPTIONAL INFORMATION
28 Are you Hispanic or Latino?
("Hispanic or Latino" is defind to mean a person of Cuban, Mexcican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)
Yes
No
29 Ethnicity

African American, Black
Asian
Native American, Alaska Native
(tribal affiliation enrolled )
Native Hawaiian, Pacific Islander
White or Caucasian
Other (specify)

STEP SIX: EXPLANATIONS/SPECIAL CIRCUMSTANCES
30

Use this space to explain any unusual expenses such as high medical or dental expenses, educational and other debts, child care, elder care, or special circumstances. Also give information for any outside scholarships you have been awarded. You may also list additional family members here. Please limit your responses to no more than 27 lines of information. Any information beyond 27 lines will not be saved. If more space is needed, use sheets of paper and send them directly to the Office of Admissions.

We strongly suggest printing and carefully reviewing information prior to your form submission.

If you have completed Step 1 through Step 6, go to Step 7 to submit the form electronically to Moravian.

STEP SEVEN: CERTIFICATION

By submitting this form you understand that you will be required to submit additional information to update or verify any estimated information on this form. Corrections or changes to this information may change financial
aid eligibility.

31 Date this form was completed (mm-dd-yyyy)
 
- -

SUBMIT ONLINE APPLICATION
 

            

 

 

 

If you have changed your mind and decided not to apply at this time, you may click the back button in your browser to go back to the page you came from.

 

 

For complete financial aid information, see our booklet Applying for Financial Aid or contact the Office of Admissions, Moravian College, 1200 Main Street, Bethlehem, PA 18018.

Office of Admissions phone numbers are 800/441.3191 or 610/861.1320 and fax number is 610/625.7930.

Financial Aid Office phone number is 610/861.1330 and fax number is 610/861.1346.


Moravian College, in compliance with federal and state laws and regulations governing affirmative action and nondiscrimination, does not discriminate in the recruitment, admission, and employment of students, faculty, and staff in the operation of any of its educational programs and activities as defined by law. Accordingly, nothing in this publication should be viewed as directly or indirectly expressing any limitation, specification, or discrimination as to race, religion, color, or national origin; or to handicap, age, sex, sexual orientation, or status as a disabled or Vietnam-era veteran except as required by law. Inquiries concerning this policy may be directed to Mr. Dennis Domchek, Vice President for Administration, Moravian College, Bethlehem, Pennsylvania 18018; 610/861-1360. NCSDO M10123 6/00