| Degree Level |
Bachelor (B.A.)
Graduate (M.A., M.F.A., Ph.D.) |
| Type of scholarship for which applying: |
Need-based
Academic Merit |
| Study Location: |
Online
On Campus |
| Your Student Status: |
New
Returning |
| Your area of studies: |
Degree
Major
Concentration |
| Name: (required) |
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| Student ID Number: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Evening Phone: |
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| Daytime Phone: |
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| Date of Birth: |
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| Citizenship: |
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| Number of Dependents: |
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| Email Address:
(required) |
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| Name, Address & Phone
of someone who will always know how to reach you: |
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| I am applying for
financial aid starting: |
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| While attending
Regent, how many hours per week do you plan to work? |
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Have you applied for the following?
(Check all that apply.) |
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| If a Virginia
Resident, have you applied for TAGP (previously
VTAG)? |
Yes
No
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| What is your
undergraduate GPA? |
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| GRE, MAT or SAT score(s)? |
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| If you attend(ed)
graduate school, what is your graduate GPA? |
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| With my "Signature
Initials" below, I'm stating that the information
given on this form
is true and complete to the best of my (our)
knowledge. I (We) agree to provide proof of
the financial information provided herein if
requested to do so by Regent University. I
(We) realize this may include a copy of my (our)
federal and/or state income tax return, current bank
statements, and other records of investments,
liabilities, etc. I (We) also realize that the
student may be denied financial aid if this
information is not provided when requested. I
have carefully read and understand the foregoing
information. |
| Date:
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Signature Initials:
Spouse Initials:
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To be considered for need-based scholarships,
applicant must also complete all
following sections: |
All new and returning
students who desire to be considered for need-based
awards must complete the following personal
financial information. This information is
confidential. The Committee will use these
data to determine financial need. Please
print this form for you records.
Please note that full-year (annual) figures are
requested. |
Cash Required:
Living Costs: |
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Cash Available |
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| Utilities: |
$
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From Savings: |
$
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| Food |
$
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Anticipated Student
Income (net) |
$
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| Tithe: |
$
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Anticipated Spouse
Income (net) |
$
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| Housing: |
$
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VA Benefits |
$
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| Automobile: |
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Income from Rental
(home, etc.) |
$
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| Loan
Payment: |
$
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Employer
Reimbursement**: |
$
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| Other: |
$
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Parents: |
$
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| Health Insurance: |
$
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Friends: |
$
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| Entertainment/Recreation: |
$
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Alimony or Child
Support: |
$
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| Daycare: |
$
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Other: |
$
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| Medical Expenses: |
$
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Total Cash Available: |
$
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| Debt Repayment: |
$
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| Miscellaneous: |
$
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Total Cash Required |
$
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| Relocation Expenses*: |
$
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-Total Cash Available |
$
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| Total Living Costs: |
$
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= Estimated Need |
$
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| Tuition (hours x cost
per hour***): |
$
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| Books & Supplies: |
$
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*New Students Only:
Include truck Rental, airfare, motel, gas, etc. |
COM/ARTS Technical Support Fee Per Credit Hour
(B.A.:$15, Grad: $25): |
$
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**If you are eligible
for tuition reimbursement from current employer,
please indicate amount. |
| Total Cash Required: |
$
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***B.A = $600 | M.A., M.F.A. = $800 | Ph.D. = $850 |
| Explain how any
shortfall between cash available and cash required
is to be met. Indicate if your parents or
other family members will be able to help. Be
specific. |
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Current Financial Condition |
| Liquid Assets: |
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| Checking |
$
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| Savings |
$
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| Other
investments |
$
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| Other |
$
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| Other Assets: |
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| House |
$
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| Auto(s) |
$
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| Other |
$
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| Total Assets: |
$
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| Liabilities: |
$
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| Home Mortgage |
$
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| Auto loan(s) balance |
$
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| Student loan(s)
balance |
$
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| Credit card(s) unpaid
balance |
$
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| Other |
$
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| Total Liabilities: |
$
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| Net Worth (Assets - Liabilities): |
$
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