FINANCIAL AID APPLICATION Make sure to have your 1040 available before beginning this application. Financial Aid Terms and Conditions Please enable JavaScript in your browser to complete this form.Applying as a: *HumanitarianAlum leaderMentorName *FirstLastBirthdate *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *At the date of your Service Year Application, what will be the status of your education? *Currently in High SchoolHigh School DiplomaCollegeCollege GraduateOtherHave you been awarded financial aid from Youthlinc before? *YesNoIf yes, please indicate year, amount, and circumstance:What is the name and location of the high school where you received or will receive your high school diploma? *School NameCity *State *For humanitarian applicants: What was your personal net income for the year prior to the Service Year?For mentor applicants: What was your family total net income for the year prior to the Service Year?Are you employed? *YesNoIf yes, what is your place of employment?Job TitleHourly rate or annual salary: Indicate how many people are in your household: *Include yourself, parents, spouse, children, and any others supported by family income (yours & others), as applicableIndicate here who these individuals are and their relationship to you *Parent InformationParent 1MotherFatherGuardianParent 1 NameFirstLastParent 1 BirthdayParent 1 AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeParent 1 PhoneParent 1 Marital StatusSingleMarriedDivorcedParent 1 Education LevelMiddle School/Junior HighHigh SchoolCollege or BeyondUnknownParent 1 Yearly Gross Income (Income before any deductions)Is parent 1 Employed? *YesNoParent 1 Job Title:Parent 2MotherFatherGuardianNot ApplicableParent 2 NameFirstLastParent 2 BirthdayParent 2 AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeParent 2 PhoneParent 2 Marital StatusSingleMarriedDivorcedParent 2 Education Level Middle School/Junior HighHigh SchoolCollege or BeyondUnknownParent 2 Yearly Gross Income (Income before any deductions)Is parent 2 Employed? *YesNoIf yes, what is the place of employment?Parent 2 Job Title:Form SubmissionsPersonal Statement *All applicants: Please provide us with a statement of why financial support is needed, including any extenuating circumstances affecting financial need. Limit: 1,000 charactersPlease Upload your 1040 Click or drag a file to this area to upload. This form is used to verify income amounts when evaluating SignatureBy signing this application you certify that all of the information you provided is true and complete to the best of your knowledge and you agree, if asked, to provide information that will verify the accuracy of your completed form. I understandFinancial Aid Terms and ConditionsParticipant SignatureParent SignatureWebsiteSubmit