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STATEMENT OF MEANS OF BIOLOGICAL PARENTS OR LEGAL GUARDIANSAll information will be kept strictly confidential. Further documentation may be required.
Family Information:Mother/Legal GuardianName:Occupation and employer:No. and ages of dependants:(for whom you are financially responsible)
Marital status:
Annual Income (A): $
(NB: total for household in which student resides)
Mother/guardian income
Father/guardian income
Student income (scholarship/summer employment)
Income from additional wage earner
Is Student self funded? Y/N
Other Income:
Rental income
Dividends/stocks
Child support
Gifts
Bursaries/scholarships
Government assistance
Other income (please specify)
Total Annual Income:
Annual Expenses (B): $
Mortgage
Rent
Land tax
Annual loan repayments
Child support/alimony
Food
Clothing
Insurance Premiums:
Buildings/contents
Health/life
Vehicle
Utilities:
Electricity
Cable TV
Gas
Phone (cell & land line)
Water
Extra-curricular/entertainment/vacation
Exceptional medical expenses
School fees for applicant (total below)
School fees for other dependants
Other expenses (Please specify)
Total Annual Expenses:
Net Income (expense) being (A) less (B):
Liabilities (D): $
Mortgage on home
Mortgage on other properties
Car loan
Boat loan
Personal loan
Credit Card ourstanding balance
Other liabilities (please specify)
Total Liabilities:
Net Income (expense) being (C) less (D):
Name of Guardian
Signature
Date
Name of Student
Signature
Date
Please outline how you plan to fund University expenses:
I/We hereby declare that the information provided herein is true and complete and that no information is omitted in relations to any of the items describing my/our income and expenses, and that I understand that, should the information provided be found to be incorrect, any financial assistance may be withdrawn. Failure to make a full and accurate disclosure will invalidate this application.
Assets (C): (total household) Year: $
House (year of purchase & purchase price)
Other property
Car
Bike
Boat
Savings / Other assets
Investments
Shares
Savings
Other assets (please specify)
Total Assets:
Student’s Statement of Education Costs
Expenses
Tuition
Room and board
Fees
Books and supplies
Travel and transportation
Other (please specify)
Total Annual Education Costs:
Father/Legal GuardianName:Occupation and employer:No. and ages of dependants: (for whom you are financially responsible)
Marital status:
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