Financial Aid

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PHSA Financial Aid Form

Please email or mail a copy of the parents 2017(and 2018 if available) tax return(s) once this application is submitted.

Applicant Information

First Name		Middle Name
Last Name		Date Of Birth
Address		City
State		Zip
Email		Drivers license Number
What is your state of legal residence?		As of today, are you married? (Also answer “Yes” if you are separated but not divorced.) *

Have you been convicted for the possession or sale of illegal drugs for an offense that occurred while you were receiving federal student aid (such as grants, loans or work-study)? Answer “No” if you have never received federal student aid or if you have never had a drug conviction for an offense that occurred while receiving federal student aid. If you have a drug conviction for an offense that occurred while you were receiving federal student aid, answer “Yes,” but complete and submit this application, and we will mail you a worksheet to help you determine if your conviction affects your eligibility for aid. *

What is the name of the high school where you received or will receive your high school diploma? Enter the complete high school name, and the city and state where the high school is located. *

Do you now have or will you have children who will receive more than half of their support from you between July 1, 2019 and June 30, 2022? *

Did you file or will you file a 2019 income tax return? *

Please Send a copy of 2019 W-2 form to admin@phsacademypg.com *

How much did you earn from working in 2019? *

Who is considered a parent? ”Parent” refers to a biological or adoptive parent or a person determined by the state to be a parent (for example, if the parent is listed on the birth certificate). Grandparents, foster parents, legal guardians, older siblings, and uncles or aunts are not considered parents on this form unless they have legally adopted you. If your legal parents are living and married to each other, answer the questions about both of them. If your legal parents are not married and live together, answer the questions about both of them. In case of divorce or separation, give information about the parent you lived with most in the last 12 months. If you did not live with one parent more than the other, give information about the parent who provided you the most financial support during the last 12 months or during the most recent year you received support. If your divorced or widowed parent has remarried, also provide information about your stepparent. *

As of today, what is the marital status of your legal parents? *

What is your parents’ state of legal residence? *

How many people are in your parents’ household? Include: • yourself, even if you don’t live with your parents, • your parents, • your parents’ other children if (a) your parents will provide more than half of their support between July 1, 2019 and June 30, 2019, or (b) the children could answer “No” to every question in Step Three on page 5 of this form, and • other people if they now live with your parents, your parents provide more than half of their support and your parents will continue to provide more than half of their support between July 1, 2018 and June 30, 2019. *

How many people in your parents’ household will be college students between July 1, 2019 and June 30, 2020? Always count yourself as a college student. Do not include your parents. Do not include siblings who are in U.S. military service academies. You may include others only if they will attend, at least half-time in 2018-2019, a program that leads to a college degree or certificate. *

What is the highest level of Education parent 1 completed? *

What is the highest level of Education parent 2 completed? *

Providing parent 1 information? You will need: Parent 1 (father/mother/stepparent) Social Security Number Parent 1 (father/mother/stepparent) name Parent 1 (father/mother/stepparent) date of birth *

Providing parent 2 information? You will need: Parent 2 (father/mother/stepparent) Social Security Number Parent 2 (father/mother/stepparent) name Parent 2 (father/mother/stepparent) date of birth *

Did your parents file a 2019 income tax return *

What was your parents’ adjusted gross income for 2019? Adjusted gross income is on IRS Form 1040 *

The following questions ask about earnings (wages, salaries, tips, etc.) in 2019. Answer the questions whether or not a tax return was filed. This information may be on the W-2 forms, or on the IRS Form 1040—Line 7 + 12 + 18 + Box 14 (Code A) of IRS Schedule K-1 (Form 1065); 1040A—line 7; or 1040EZ—line 1.How much did parent 1 (father/mother/stepparent) earn from working in 2019? *

The following questions ask about earnings (wages, salaries, tips, etc.) in 2019. Answer the questions whether or not a tax return was filed. This information may be on the W-2 forms, or on the IRS Form 1040—Line 7 + 12 + 18 + Box 14 (Code A) of IRS Schedule K-1 (Form 1065); 1040A—line 7; or 1040EZ—line 2. How much did parent 2 (father/mother/stepparent) earn from working in 2018? *

In 2018 or 2019, did anyone in your parents’ household receive: (Check all that apply.) *

Supplemental Security Income (SSI)Temporary Assistance for Needy Families (TANF)Supplemental Nutrition Assistance Program (SNAP)Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)Free or Reduced Price School LunchNone

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

As of today, what is the net worth of your parents’ investments, including real estate? Don’t include the home in which your parents live. Net worth means current value minus debt. *

As of today, what is the net worth of your parents’ current businesses and/or investment farms? Don’t include a family farm or family business with 100 or fewer full-time or full-time equivalent employees. *

What amount can the Family afford to pay of the Tuition? Payment plans must be paid in full and on time. *

Who will be paying for tuition? (Select All that apply) *

MotherFatherFamilyRelativeFamily Friend

Do you certify that you answered all the questions above correctly? *

In 2018 or 2019, did anyone in your parents’ household receive: (Check all that apply.) *