Tuition Assistance Application

General Information

Student Names and Grade They Will Be Attending

If new to MHCA, student's previous school:

Father's Name

First Name

Last Name

Mother's Name

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Number

Cell Phone Number

Church Affiliation

Pastor's Name

Dependent Information

Please list all information for each dependent child who will not be attending MHCA.

Include Name, Age, & School.

Sources of Income

Source and Estimated Income of Each:

Please make a list of all streams of income and their frequency.

Please email an attachment of your pay stubs to finance@mounthopechristian.com

Who is responsible for paying tuition?

Are you receiving tuition assistance from any other organization or individual:

Yes

What is the maximum monthly tuition payment you can make:

Special Circumstances

Please explain any circumstances that the Financial Assistance Committee should consider when determining your eligibility for financial assistance. Help the committee make the appropriate decision by providing as much information as possible.

Please Write Your Full Name in the Box Below:

By typing your name below, you are signing this application electronically.

First Name

Last Name

Date Completed

YYYY

Tuition Assistance Application

MT. HOPE CHRISTIAN ACADEMY

PHYSICAL LOCATION