LYCE FRANAIS DE NEW YORK - Lycée Rochambeau

LYCÉE ROCHAMBEAU FRENCH INTERNATIONAL SCHOOL2008-2009Application for Financial AidDUE: JUNE 18, 2008Page 1A limited amount of school financial assistance is granted each year to our students on a needs basis. TheScholarship Committee of the Lycée Rochambeau Foundation examines the applications submitted. Allinformation supplied will be considered strictly confidential.This form must be completed for all requests for financial assistance.Family Name:Home Address:Home Telephone:Name of Children Attending Lycée Rochambeau1.2.3.4.5.Name: Grade in 2008-2009 Social Security No.Status: Married Separated Divorced SingleFather’s InformationMother’s InformationName:Occupation:Name of Business:Address of Business:Phone Number:Annual Salary:Alimony Received:Business Income:Capital Gains:Other Income:(state nature & source)Total IncomeNOTE: You must attach a copy of your 2006and 2007 Income Tax Returns including W-2 Forms, 1099,Form 1040 and all schedules.

2008-2009Application for Financial AidFamily Name:Page 2Additional InformationHousing:If you OWN your home: Year Purchased:Purchase Price:Mortgage Payment:Please provide proof of mortgage paymentIf you RENT your home:Monthly Rent:Please provide a copy of your rental lease agreementOther Real Estate (state nature and address)1 Year Purchased: Purchase Price:Mortgage Payment:2 Year Purchased: Purchase Price:Mortgage Payment:Other Funds not shown as income (state nature):List all cars owned by the family (include Model/Year):Please submit a cover letter that contains any additional information or clarifying statements which may help theFoundation to understand your particular situation. Use this opportunity to list other dependents, extraordinaryfinancial obligations, not mentioned in the application above.All families in the school assume all or part of the cost of their child’s tuition. In view of your financialcircumstances, what in your mind would be the financial aid amount which the Lycée Rochambeau Foundationmight provide to your child(ren)?I/We understand that if any inaccurate or misleading information is contained on this application or in anysupporting material it will cause this application to be denied and any financial aid assistance to be revoked. I/Wedeclare the above statements to be true and accurate.Signature of Father Date Signature of Mother Date