P.O. Box 255, Manhasset, New York 11030
Web Address: www.msaainc.org Email: Info@msaainc.org
You will need a copy of your College/Vocational SCHOOL FINANCIAL AID LETTER to complete Part 1 of this application.
REQUIRED ATTACHMENTS: High School Transcript and School Financial Aid Letter
Section A – Tell us about YOU:
Student Name:_______________________________________
Permanent Address:________________________________ City & State_______________________ Zip______
Home Phone: ( )_______- _________ Cell Phone: ( )_______-___________
Email Address: ______________________________________________
Date of Birth: _____/_____/_____ Social Security Number: __________________
Place of Birth: _____________________
Are you a US Citizen? ______________ If not, are you a legal US Permanent Resident?_______________
Parent(s)/Guardian with whom you reside: ________________________________________
Section B - Tell us about your HIGH SCHOOL (Please attach your transcript.)
High School Attended: ______________________________________ City ____________________
High School Graduation Date (or date GED Received): ____/____/____
GPA _______________ Weighted GPA________________
Section C – Tell us about your WORK HISTORY:
Employment Dates Employer City/State Hours/week Total Income
_______________ ________________________ ________________ _________ $________
_______________ ________________________ ________________ _________ $________
How much will you contribute to the cost of your education? $______________
Section D – Tell us about the SCHOOL YOU PLAN TO ATTEND:
School Name:______________________________ Address:__________________________________________
What is the annual cost of: Tuition$________ Fees$________ Room$_______ Board$_______
When will you begin classes? Month ________Year__________
When do you expect to graduate from this institution? _____/______/______
Section E – Tell us about your FINANCIAL AID LETTER
Please refer to the Financial Aid Letter you received from your school to answer the following questions.
Date of School Aid Letter: ____/___/___ Does the letter say that it is an estimate? (Y/N)______
The MSAA Selection Committee will review letters with estimated or preliminary amounts.
However, MSAA requires the final letter before an MSAA award can be approved.
How much were you offered for the following types of Aid?
Please list the Total Annual-full school year-amount.
a) PELL Grant $ _______________ b) FSEOG Federal Supplemental Education Grant $ _________
c) Subsidized Stafford Loan $__________ d) Unsubsidized Stafford Loan $_____________
Please attach a copy of the School Financial Aid Letter.
Section F – Tell us about any OTHER GRANTS OR LOANS
Please list any other financial aid awards you expect to receive for the coming school year? Grant or Loan?
From: Sponsor Name Amount (Per School Year) Indicate Grant or Loan
Manhasset SCA Grant $_____________________ __________________
________________________________________ $_____________________ __________________
________________________________________ $_____________________ __________________
________________________________________ $_____________________ __________________
Section G – Tell us your CAREER PLANS
Briefly state your career goals: ______________________________________________________________________
________________________________________________________________________________________________
Section H – Tell us ANYTHING ELSE you think we should know
Additional Comments: Please use this space (or attach a separate sheet) for any additional comments.
Section I – PLEASE READ & SIGN
Applicant’s Statement & Consent: I hereby certify that the information submitted herewith is true, accurate and correct. I agree to provide any official documentation necessary to verify the above information. The MSAA Selection Committee has my authorization and consent to meet with representatives of my high school’s guidance office to review and discuss this application.
Student Signature:_______________________________________ Today’s Date_____/____/____
Print Student Name:_______________________________________________________________
REQUIRED PART 1 ATTACHMENTS: High School Transcript and School Financial Aid Letter
Part 2 must be completed by your custodial Parent/Guardian; Part 3 (if applicable) by any non-custodial Parent.
Mail Parts 1, 2 and 3 plus attachments to MSAA, P.O. Box 255, Manhasset, N.Y. 11030
COMPLETED APPLICATIONS MUST BE POSTMARKED ON OR BEFORE JUNE 8, 2007
For (Student’s Name): _______________________________________________________
You will need a copy of Student Aid Report (SAR) to complete Part 2 of this application
Attachments required: Copy of Student Aid Report (SAR) and CSS PROFILE (if required by the school).
Section A – About You
Parent/Guardian Name: _______________________________________
Home Phone: ( )_______- _________ Cell Phone: ( )_______-___________
Email Address:____________________________________________
Parent/Guardian Date of Birth: _____/_____/_____ Social Security Number: __________________
Do you have any dependent children other than applicant?______; If yes, how many? ______; Their Ages?_________
Section B – Your Home
Address of Primary Residence ________________________________________________________________
Do you rent this home? (Y/N) ___________ Annual Rent $___________________
Do you own this home? (Y/N)___________ Estimated current Market Value $_____________
If owned, Current Amount of outstanding debt on this home, Mortgage and/or Equity Line $_______________
Section C – Your Household’s Total Assets
Regarding ALL other Assets of this household (held in the U.S. or abroad) state:
Market Value of Cash and Investment Portfolio $___________________.
Market Value of ALL Other Asset Holdings (including real estate etc.) $____________________
Make/Model of Household Automobiles: Year Owned or Leased?
__________________________________ _________ ____________
___________________________________ _________ ____________
Section D – Your Household’s Occupations & Incomes
Father/Stepfather or Guardian Mother/Stepmother or Guardian
Name: ___________________________ ________________________________
Occupation: ___________________________ ________________________________
Employer: ___________________________ ________________________________
Annual Salary $__________________________ $_______________________________
Retired or Unemployed?____________________ _________________________________
Last Date of Employment?____/_____/________ ______/_____/_____
Section E – Student Aid Report Information
Please refer to the Student Aid Report (SAR) to answer the following questions.
Date of SAR ____/___/___
What does the SAR state as your Effective Family Contribution (EFC) $__________
Please attach a copy of the SAR and also attach a completed copy of the College Board’s financial aid application (CSS PROFILE), if the PROFILE was required by the school.
The MSAA Selection Committee will review applications with estimated or preliminary amounts. However, MSAA requires completed Application Parts 1, 2 and 3, the final SAR report and School Financial Aid Letter (required in Student’s Part 1 of this application) before an MSAA award can be approved
Please send any updated reports as they are received. Deadline for completed documents is July 31.
Section F – Non-Custodial Parent Information (if applicable)
Are the student applicant’s parents Separated or Divorced? (Y/N)_____ If “no”, please proceed to Section G.
Date of Separation or Divorce:___/___/___
Non-Custodial Parent Name:___________________________________ Occupation:_______________________
Amount you receive in annual child support for this student? $______________
When is support to end?______/___/____
Amount non-custodial parent is required to contribute towards applicant’s educational expenses? $___________
If applicable, please send the enclosed PART 3 Non-Custodial Parent Form to any non-custodial parent for completion.
Section G – Additional Comments
Please use this space (or attach a separate sheet) to explain any other circumstances that may bear on this applicant’s need for financial aid.
Section H – PLEASE READ & SIGN
Parent / Guardian’s Statement & Consent: I hereby certify that the information submitted herewith is true, accurate and correct. I agree to provide any official documentation necessary to verify the above information. The MSAA Selection Committee has my authorization and consent to meet with representatives of the student applicant’s high school’s guidance office to review and discuss this application.
Parent/Guardian Signature: _____________________________________ Today’s Date_____/____/____
Print Name:_______________________________________________________________
REQUIRED PART 2 ATTACHMENTS: SAR Report and CSS Profile.
Part 1 must be completed by the student applicant & Part 3 (if applicable) by any non-custodial Parent.
For (Student’s Name): _______________________________________________________
Dear Parent,
Your child is submitting an application to The Manhasset Student Aid Association for educational financial aid. In order to be considered, we require your completion of this Non-Custodial Parent Application Form. Please return it to us as soon as possible so that we can properly evaluate the need for aid and our organization’s ability to provide funding.
Section A – About You
Non-Custodial Parent Name: _______________________________________
Home Phone: ( ) _______- _________ Cell Phone: ( ) _______-___________
Email Address: ____________________________________________
Non-Custodial Parent Date of Birth: _____/_____/_____ Social Security Number: __________________
Do you have any dependent children other than applicant? ______; If yes, how many? ______; Their Ages? _________
Section B – Your Home
Address of Primary Residence ________________________________________________________________
Do you rent this home? (Y/N) ___________ Annual Rent $___________________
Do you own this home? (Y/N)___________ Estimated current Market Value $_____________
If owned, Current Amount of outstanding debt on this home, Mortgage and/or Equity Line $_______________
Section C – Your Household’s Total Assets
Regarding ALL other Assets of this household (held in the U.S. or abroad) state:
Market Value of Cash and Investment Portfolio $___________________
Market Value of ALL Other Asset Holdings (including real estate etc.) $____________________
Make/Model of Household Automobiles: Year Owned or Leased?
__________________________________ _________ ____________
___________________________________ _________ ____________
Section D – Your Household’s Occupations & Incomes
Non-Custodial Parent Non-Custodial Parent’s Spouse
Name: __________________________ ________________________________
Occupation: __________________________ ________________________________
Employer: __________________________ ________________________________
Annual Salary $_________________________ $_______________________________
Retired? /Unemployed? ____________________ ________________________________
Last Date of Employment? ____/_____/_______ ______/_____/_____
2006 IRS Adjusted Gross Income $__________ $_______________________________
Section E – Applicable Child Support
Amount you pay in annual child support for applicant? $______________
When is support to end? ______/___/____
Amount you are required to contribute towards applicant’s educational expenses? $_________________
Section F – Additional Comments
Please use this space (or attach a separate sheet) to explain any other circumstances that may bear on this applicant’s need for financial aid.
Section H – PLEASE READ & SIGN
Parent’s Statement & Consent: I hereby certify that the information submitted herewith is true, accurate and correct. I agree to provide any official documentation necessary to verify the above information. The MSAA Selection Committee has my authorization and consent to meet with representatives of the student applicant’s high school’s guidance office to review and discuss this application.
Non-Custodial Parent Signature: _____________________________________ Today’s Date_____/____/____
Print Name: _______________________________________________________________
Part 1 must be completed by your child.
Part 2 must be completed by custodial parent/guardian.