Financial Aid Worksheet

To be completed by an officer of the college or university and sent, along with the completed application, to:

The Edmund F. Maxwell Foundation
Post Office Box 22537
Seattle, Washington 98122-0537
Figures accepted only for the Academic Year: 2010-2011


Student Name:____________________________________________________________

Student ID No. (when issued):_____________________________

Student will live: __On-campus __Off-campus __Parent's home

Marital Status:   __ Single    __Married    No. of children:_____

Student Budget Student Resources
Tuition & Fees ________________       Parent Contribution ________________
Room & Board ________________       Student Contribution ________________
Books & Supplies ________________       Other ________________
Transportation ________________

Personal Expenses ________________

Other ________________

TOTAL ________________       TOTAL ____________________


DIFFERENCE (Financial Aid Required):		 ____________________
Describe sources of
Grants and Scholarships		 Y/N1 Amount
Total Grant and Scholarship
Aid Available:
1 - Is Award based on Financial Need, as determined in accordance with Federal or institutional standards? Please indicate as to each scholarship or grant whether it is based on financial need/subsidized or unsubsidized.
Loans and Work-Study Y/N2 Y/N3 Amount
Total Loan and Work-Study
Aid Available:
2 - Is Award based on Financial Need, as determined in accordance with Federal or institutional standards? Please indicate as to each loan or workstudy whether it is based on financial need/subsidized or unsubsidized.
3 - Is Loan Subsidized?
(From above) Financial Aid Required
(Less) Total Grant and Scholarship Aid Available
(Equals) Additional Amount Needed
Total Loan and Work-Study Aid Available

Comments :



I CERTIFY THAT: (i)this institution receives its fundamental support from sources other than taxes, and is accredited by an agency recognized by the U.S. Secretary of Education, namely: ______________________________________, and (ii) this student has filed a Free Application For Student Aid (FAFSA) and qualifies for financial aid. 


Signature ______________________________Title________________________________

College or University ____________________________________Date ______________

Mailing Address __________________________________________

Email ____________________________________________________

Address to which scholarship funds should be mailed.

College or University ______________________________________________

Department and/or address:  ________________________________________

City, State, Zip Code:  ______________________________________________

For Academic Year 2010-11

The Edmund F. Maxwell Foundation
Post Office Box 22537
Seattle, Washington 98122-0537
http://www.maxwell.org
admin@maxwell.org