Highlights Foundation Scholarship Application Form Page 4
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4SUPPLEMENTAL INFORMATION
Section D: Asset Information
What is it worth today?
What is owed on it?
14. Cash, savings, and checking accounts
$ ____________________
15. Home
$ ____________________
$ ______________________
16. Other real estate and investments
$ ____________________
$ ______________________
17. Business or farm
$ ____________________
$ ______________________
Section E: Expenses
(Please refer to the tax period your are using above.)
18. Medical and dental expenses not paid by insurance ...........................................
$ ____________________
19. Elementary, junior high, and high school tuition
for dependent children ........................................................................................
$ ____________________
20. College tuition for dependent children ..............................................................
$ ____________________
21. READ AND SIGN. All the information on this form is true and complete to the best of my knowledge.
______________________________________________________ __________________________________
(Applicant)
(Date)
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Parent category: Business