Financial Aid Application
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1
22015-2016
OFFICE OF FINANCIAL AID
309-341-7149 Phone
309-341-7453 Fax
Financial Aid Application
Complete, sign, and return this form to the Office of Financial Aid, Knox College, 2 East South Street, Galesburg, IL 61401, by fax
to 309-341-7453, or by e-mail to financialaid@knox edu. Please print using a dark pen. This form is used to verify data provided by
you on the Free Application for Federal Student Aid (FAFSA) and helps determine your eligibility for financial aid from Knox funds. If
your family has special circumstances such as a reduction in 2015 income, high medical or dental expenses, private school tuition,
or educational debts, download a Special Circumstances Form at /specialcircumstances after you file the FAFSA.
PART A - STUDENT PERSONAL INFORMATION
Ms.
Student’s legal name
Mr. ____________________________________________________________________________________________
Last
First
Middle initial
Date of bir th__________ /__________ /__________ Social Security Number ____________________________________________________
month
day
year
Permanent address _____________________________________________________________________________________________________
Number, street and apar tment number
_______________________________________________________________________________________________________________________
City
State
Z ip
Home Phone__________________________ Cell Phone__________________________ E-mail _______________________________________
PART B - PARENT INFORMATION
Parent information should be provided for the parent(s) and stepparent who live in your primar y household regardless of whether or
not they are married.
Mark one:
Parent
Stepparent
Other: ______________
Mark one:
Parent
Stepparent
Other: ______________
Name __________________________________________________
Name __________________________________________________
Occupation _____________________________________________
Occupation _____________________________________________
Employer _______________________________________________
Employer _______________________________________________
Work/Cell phone ________________________________________
Work/Cell phone ________________________________________
E-mail address __________________________________________
E-mail address __________________________________________
PART C - HOUSEHOLD MEMBERS
In the box below, fill in the information about the people in your primary household between July 1, 2015 and June 30, 2016.
•
•
•
Include:
yourself
your parent(s)
your parent(s)’ dependent children if they will receive more than half of their suppor t from
your parent(s) or if they would be required to provide parental information when applying for federal student aid.
Note: If you answered “yes” to any question between #46 and #58 on the FAFSA and have been determined to be independent for
financial aid purposes, include yourself and other people if they meet the criteria listed above.
Include other people only if they live with and receive more than half of their suppor t from your parent(s) or you at this time, AND
this suppor t will continue between July 1, 2015 and June 30, 2016. The number of household members and the number in college
must match the answers you provide on the FAFSA.
List all household members below.
Will attend college
Name of
Year in
Tuition,
Amount of
Relationship
at least half-time
college
college
fees, room,
Scholarships
parents’
Name
Age
to you
in 2015-2016
in 2015-2016
in 2015-2016
and board
and gift aid
contribution
1.
Self
Yes
No
Knox
—
—
—
2.
Yes
No
3.
Yes
No
4.
Yes
No
5.
Yes
No
6.
Yes
No
7.
Yes
No
8.
Yes
No
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