The questionnaire below is designed to help provide an estimate of your financial aid eligibility. It is not an application for financial aid. An official financial aid award letter cannot be provided until you have been admitted and we have received the results of your Free Application for Federal Student Aid (FAFSA) for 2012-2013.

This questionnaire is appropriate for determining eligibility for dependent students only. If you have questions about applying to Alderson-Broaddus College, please contact the Admissions Office. If you have questions about your financial aid status, please call the Office of Financial Aid. Both offices can be reached at 1-800-263-1549 or by e-mail: admissions@ab.edu.

* The term “parents” on this questionnaire is defined to be the student’s mother and/or father, or adoptive parents. If the student’s parents are separated or divorced, provide information for the parent with whom the student lived for the greater portion of the year. If the student’s natural parents have divorced and remarried, report information regarding the stepparent also, if the student lives in his/her household. If one of the student’s parents is deceased, report information for only the surviving parent. (Note that grandparents, foster parents, and legal guardians are not parents.)

INSTRUCTIONS FOR DEPENDENT STUDENTS
19. Number of family members: Write in the number of people that your parents will support between July 1, 2011 and June 30, 2012. Include yourself, your parents, and other children who will get more than half of their support from your parents. If your parents support others, call us to determine if they should be included.

20. Number in College: Of the children included in question 19, how many will be enrolled at least half-time in college degree or certificate programs between July 1, 2012 and June 30, 2013? Be sure to include yourself. If your parents are in college, do NOT include them.

24. 2011 Income earned from work: If you answered question 22, include “wages, salaries, tips, etc.” from your parents’ 2011federal tax return. Report your father’s/stepfather’s and mother’s/stepmother’s earnings separately.  If you skipped question 22, include your parents’ earnings from work in 2011. Add up earnings from your parents’ W-2 forms and other earnings from work that are not reported on W-2 forms.

25. 2011 Untaxed income: Include any deductible IRA/Keogh payments made in 2011 or untaxed portions of 2011 payments to 401(k) and 403(b) plans, housing, food and living allowances for military, clergy, etc., 2011 nontaxable interest and dividends, and child support, worker’s compensation, etc., received in 2011.

30. Real estate and investments: Include real estate (excluding primary residence), stocks, bonds, money market funds, mutual funds, CDs, trust funds, commodities, precious metals and other investments; Do not include the value of the family home or retirement plans.

By completing and submitting this form you agree: This information is true to the best of your knowledge. You understand that the results from this form will be an estimate and that official awards for admitted students are made only after a processed 2012-2013 FAFSA is received by the Alderson-Broaddus Financial Aid Office.

     
     
     
wf      
     
wf      

(Number and Street - include apt. number) City, State, Zip

     

Married or Unmarried (Single, divorced, separated, or widowed)

     

MM/DD/YYYY

     

(Y or N)

     

(Y or N)

     

(Y or N)

     

(Y or N)

     

(Y or N)

     

(Required)

     

(Required)

     

(Required) If SAT, only Critical Reading & Math score combined.

     

(Required)

     

(Y or N)

     
$ .00
     
$ .00

(Even if the student does not file)

     
$ .00

Including money paid on your behalf from a non-custodial parent
(See instructions for question 24)

     
$ .00
     
$ .00
     
$ .00

(See instructions for question 29)

     
$ .00
     

Married or unmarried (Single, divorced, separated, or widowed)

     
     
     

Please use two-letter US Post Office abbreviation

     

Please use two-letter US Post Office abbreviation

     

(See instructions)

     

(see instructions)

     

(Choose - Form 1040, Form 1040A, For 1040EZ, or No Tax Return Filed/Skip this section.) Use the information on your parents 2011 Federal income tax return to complete this section.

     
$ .00

(IRS form 1040-line 37; 1040A-line 21)

     
$ .00

(IRS form 1040-line 55; 1040A-line 35)

     
$ .00

(See instructions)

     
$ .00

(see instructions)

     
$ .00

(see instructions)

     
$ .00
     
$ .00
     
$ .00
     
$ .00
     
$ .00

(Don't include lump sum pension funds.)

     
$ .00

(Market value minus debt. Don't include a family farm if it is your principal residence and your parents participate in its operation.)

     
Parents' Information Section (below)

If a question doesn't apply to you, please enter 0 or N/A as your answer.