Request for Financial Aid - Summer Scholars - Session I Pre-College Programs

Request for Need-Based Financial Assistance
2023 Notre Dame Summer Scholars Program

If a student wants be considered for financial assistance, parents or guardians must complete this form in its entirety.

Very limited need-based financial aid, including partial scholarships, is available. Application fee waivers are granted rarely and only in extreme circumstances.

The Office of Pre-College Programs does not offer merit-based financial assistance or scholarships.

Parent Information

Name of Parent/Guardian Completing Form

Parent/Guardian Email Address

Parent/Guardian Contact Phone Number

Student Information

Student's First Name

Student's Last Name

Student's Birthdate

Student's Email Address

High School Name

CEEB Code

Student's Mailing Address

Country

Street

City

Region

Postal Code

Financial Information

For what are you requesting financial assistance? Mark all that apply. Please note that requests for financial assistance must be received no later than February 13, 2023 for Summer Scholars.

Summer Scholars Application Fee Waiver (granted in extreme financial circumstances only)

Summer Scholars Tuition Assistance (if accepted into program)

In 2021 or 2022, did you, any other parent/guardian of Student, or anyone in your or the Student's household receive benefits from any of the federal programs listed?

Mark all that apply.

Supplemental Security Income (SSI)

Food Stamps

Free or Reduced Price Lunch

Temporary Assistance for Needy Families (TANF)

Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

Total number of members in household:

Estimated total annual household income:

Estimated total value of Student's parents'/guardians' savings, retirement and investments:

Estimated annual Student earnings:

Amount Student can contribute toward program costs:

Amount Student's parents/guardians can contribute toward program costs:

In the section below, please describe what factors are affecting your and your family's ability to contribute to the program costs. Your description should include pertinent family information such as marital status of Student's parents/guardians, number of children in the family and their ages, significant educational or medical expenses, and any special circumstances we should consider in reviewing this request for financial assistance. This section must be completed in order to be considered for financial assistance.

Please note that incomplete forms will not be reviewed. Submission of this form does not guarantee acceptance into a program nor does it guarantee any financial assistance. Should Student be accepted into a program, Student will be notified of any financial assistance award in Student's acceptance letter.

Thank you for taking the time to complete this form.