Financial Aid Application – Flying Manes Therapeutic Riding

FINANCIAL AID APPLICATION

Instructions

This financial aid application is for lesson fees at Flying Manes Therapeutic Riding, Inc. All requested information must be provided complete and in full to be considered for an award. All information will be kept confidential and will be made available only to the Flying Manes Financial Aid Committee. Financial aid awards are based solely upon need. Due to limited funds please apply for financial aid only after careful assessment of your needs.

Lesson fees cover approximately 30% of program costs. As a not for profit organization we are able to subsidize the remainder based on the generous donations from individuals, corporations, and foundations. Flying Manes is committed to enrolling participants regardless of financial means and offers additional assistance in the form of payment plans and adjusted fees to those unable to pay the established lesson fees at once or in full. Financial aid is granted based strictly on need and only when a prospective participant has been accepted and scheduled into the program. Families of continuing participants must renew their financial aid requests on an annual basis by submitting a newly completed Financial Aid Application.

Financial aid applications are considered on a first come, first serve basis. This form should be filed as early as possible. All requested information must be provided. Any information provided in this application regarding income and expenses must be proven by documentation that reflects the exact amount entered in this form. Be sure to have ready to upload with this application scans or pictures of your most recent W-2 forms, social security statements, proof of income, monthly utility bills, credit card statements, mortgage and rent statements etc. Flying Manes is unable to consider an application until all information has been submitted.

The Financial Aid Committee reviews the applications and may find it necessary to request additional information, which is arranged on a confidential basis. Financial aid is awarded in the form of adjusted payment plans and/or credit toward the established lesson fees for scheduled sessions. Final determination of financial aid awards is based on the demonstrated financial needs of the applicant and the funds available for financial aid at Flying Manes Therapeutic Riding, Inc. Flying Manes notifies the applicant of the award in writing. Please contact us at info@flyingmanes.org or by calling (917) 524-6648 with any questions you may have.

Participant Information

Participant Name *

First

Last

Date of Birth *

Applicant Information (Parent/Guardian #1)

Name of Applicant (Parent/Guardian #1) *

First

Last

Email *

Cell Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Occupation *

If unemployed, enter "unemployed".

Employer *

If unemployed, enter "unemployed".

Employed since: *

If unemployed, enter first day of unemployment.

Current Relationship Status - Married/Separated/Divorced/Widowed/Other (please describe). *

Spouse's Name

First

Last

Custody Status of Participant - Full/Shared/Visiting/None/Other (please describe): *

Parent/Guardian #2

Name of Parent/Guardian #2 *

First

Last

Email *

Cell Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Occupation *

If unemployed, enter "unemployed".

Employer *

If unemployed, enter "unemployed".

Employed since: *

If unemployed, enter first day of unemployment.

Current Relationship Status - Married/Separated/Divorced/Widowed/Other (please describe): *

Spouse's Name

First

Last

Custody Status of Participant - Full/Shared/Visiting/None/Other (please describe): *

Members of your Household

How many people live in your household, including yourself? *

Please list the name, date of birth, and relationship to you for any people who live in your household. Please indicate if these members of your household have a regular income through a job, social security, unemployment etc.

Name of Member #1 of your Household

First

Last

Date of Birth

Relationship to you

Does this member of your household have a regular income through a job, social security, unemployment etc? Please be specific:

Name of Member #2 of your Household

First

Last

Date of Birth

Relationship to you

Does this member of your household have a regular income through a job, social security, unemployment etc? Please be specific:

Name of Member #3 of your Household

First

Last

Date of Birth

Relationship to you

Does this member of your household have a regular income through a job, social security, unemployment etc? Please be specific:

Name of Member #4 of your Household

First

Last

Date of Birth (copy)

Relationship to you

Does this member of your household have a regular income through a job, social security, unemployment etc? Please be specific:

For any additional members of your household, please list the name, date of birth, and relationship to you. Please describe if these members of your household have a regular income through a job, social security, unemployment etc:

INCOME

Wages/Salary of all Working Household Members

Please list the exact amount of every household member's (including yourself) MONTHLY wage or salary from all primary/secondary jobs. *

YOU MUST ATTACH A COPY OF EVERYONE'S MOST RECENT PAY STUBS AND MOST RECENT W-2 TAX FORM(S) ISSUED BY EMPLOYER(S).

Unemployment Benefits

If you or anyone living in your household receive(s) unemployment benefits, please list names and how much you/they receive per month:

Date you/other household members became unemployed:

Retirement Benefits

If you or anyone living in your household receive(s) retirement or social security benefits, please list names and how much you/they receive per month:

Disability Insurance Benefits

If you or anyone living in your household receive(s) disability insurance/social security benefits, please list names and how much you/they receive per month:

Child Support

If you or anyone living in your household receive(s) child support payments/alimony for any of your/their children, please list for each child separately the amount received per month:

Other Benefits or Income

Please state the total amount of any other types of income you and anyone living in your household receive per month:

Total Income

Please add all amounts you entered above and list the total monthly income for you and all members of your household here: *

EXPENSES

Housing Cost

Please enter the amount of your monthly rent or mortgage payment:

Credit Card Payments

Please enter the amount of your total minimum monthly credit card payments:

Insurance Payments

Please enter the total of your monthly (health, car, etc.) insurance payments:

Car Payments

Please enter any monthly car payment:

Child Support/Alimony Payments

Please enter the amount of any monthly child support or alimony you pay:

Other Debt and Financial Obligations

Please describe any other debt or financial obligations:

Total Expenses

Please add all amounts you entered above and list the total monthly expenses for you and all members of your household here: *

Additional Information

Please explain any other factors that you would like the Financial Aid Committee to consider when evaluating your financial aid application:

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