First Lutheran Church & School
Pastor Jeremy May 580 - 762 - 1111
1104 N. 4th St—Ponca City, OK 74601
Principal David Birnbaum
580 - 762 - 9950 School Fax 580-762-4243
“Grow at First” FINANCIAL AID APPLICATION 2017 – 2018
PLEASE RETURN THIS APPLICATION WITH APPROPRIATE DOCUMENTS An Educational Assistance Fund has been established to provide funding for a limited number of financial aid awards.
Father’s Name:
Employer:
Mother’s Name:
Employer:
Guardian’s Name:
Employer: Parent/Guardian contact number:
Address:
Please supply all information requested below. Information will be kept confidential. 1. Number of children in family: Number of children attending First Lutheran: Number of children in high school: Number of children in college: Total number of people living in household: 2.
Name and future grades of children that are/will be attending First Lutheran: Name:
Enrolling in Grade:
Name:
Enrolling in Grade:
Name:
Enrolling in Grade:
Name:
Enrolling in Grade:
3.
Marital status: Married:_____ Separated:_____ Single:_____ Divorced:_____
4.
Combined annual (yearly) income Salary: Public Assistance: Unemployment:
Do you expect any changes in these figures during the upcoming school year? ___Yes ___No If yes, please explain:
Child Support: Retirement: Other: TOTAL:
Growing up, Reaching Out, and Walking together with Jesus at First Lutheran Church & School. “Like new born babies, crave pure spiritual milk, so that by it you may grow up in your salvation, now that you have tasted that the Lord is good.” 1 Peter 2:2-3