Aid For Part-Time Study (A.p.t.s.) Application printable pdf download

Aid For Part-Time Study (A.p.t.s.) Application

Aid for Part-Time Study

(A.P.T.S.) Application

Academic Year

Submit completed application to your school's Financial Aid Office

SCHOOL NAME

2. Date of Birth (Use numbers only)

Social Security Number

Month

Day

Year(CCYY)

First Name

Last Name

4. Address: number, street, apartment

City or Town

State

Zip Code

Home Phone Number

Work Phone Number

E-mail Address

Are you a legal resident of New York State?

(See instructions on page 1.)

YES

Check the box that applies to you (See instructions on page 2.)

Citizen

Eligible Non-Citizen

Not a Citizen or Eligible Non-Citizen

7. Marital status

(Check only one box)

Married

Separated

Unmarried (single, divorced or widowed)

8. If married, enter the date you were married. If separated/divorced or widowed,

give earliest date on which you were separated/divorced or widowed.

Year(CCYY)

Month

Have you graduated, or will you graduate from high school; or have you received or will you receive a GED?

YES

10.

Will all or part of your tuition charges be paid or reimbursed by an employer?

YES

If yes, enter amount if known $

APPLICANT/SPOUSE (IF MARRIED) INCOME STATEMENT - (All applicants must answer Questions 11 and 12.)

11.

Enter ex

Taxable Income (NTI) in the boxes pro

emptions and Net

vided.

Applicant's Separate NTI

Spouse's Separate NTI Only

OR Joint NTI with Spouse

Income

Exemptions

.00

DOLLARS

Cents

DOLLARS

Cents

HE8073 (Rev. 03/2003)

Aid For Part-Time Study (A.p.t.s.) Application

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