This Is A Request For Financial Aid To Cover Child Care Fees As

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340 DeKalb Pike Blue Bell, PA 19422
101 College Drive Pottstown, PA 19464
To:
Financial Aid Office
From:
Phone:
Date:
Re:
Child Care Fees
CC:
This is a request for financial aid to cover child care fees as follows.
Weekly fee
$
Multiplied by number of weeks*
X 16
Total tuition for the semester
$
Less payments**
-
Total transfer
$
*Must be the number of weeks from the financial aid payment start date to the end of the semester.
Partial semesters not permitted.
**Financial does not cover the $30 registration fee and $15 insurance fee. This must be paid at the
time of registration. Payment for any additional hours, not included above, is the responsibility of
the student/parent. The payment transfer will occur approximately 5 weeks after the start of the
semester.
No changes may be made to this form. If a change is requested a new form must be completed with
all signatures.
I approve the transfer of financial aid funds indicated above to pay for child care. I understand that I
remain responsible for child care tuition charges if financial aid is cancelled or decreased for any
reason.
________________________________ ________________________________ Date:
Student/Parent Signature
Printed Name
Approved by:
_________________________________________________________________ Date:
Deborah Ravacon/Children’s Center
_________________________________________________________________ Date:
Juanita Maniscalco/Business Office
This agreement becomes effective when all signatures are complete.

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