Living Wisdom High School

14618 Tyler Foote Rd  Nevada city, CA 95959; (530) 478-7640

Tuition Adjustment Application 2018-2019

Please complete all questions, date and sign the form, and and enclose your 2017 Federal Income Tax return, or if you live outside of the U.S.A., include information that verifies your income from the past year.

Parent Name(s) _______________________________________________________________________

Address  ______________________________________________________________________________

City/State/ZIP ______________________________________________________ Country __________

Phone (Day & Evening) _______________________________________ Email ___________________

Children enrolled (or to be enrolled)

Name__________________________________________________________ Grade________

Name__________________________________________________________ Grade________

Please describe your marital status, family composition, and number of dependents.

_______________________________________________________________________________________

_______________________________________________________________________________________

Please describe your employment situation and other sources of financial support.

_______________________________________________________________________________________

_______________________________________________________________________________________

Please list your significant assets and include the amounts (savings, stocks, real estate, etc.).

_______________________________________________________________________________________

_______________________________________________________________________________________

Based on the schools tuition rates (see this link), how much assistance are you seeking?

______________________________________________________________________________________

The information submitted above, which is true and complete to the best of my/our knowledge, is in support of my/our application to Ananda Living Wisdom School for tuition adjustment. We understand that the school will treat the information we have supplied confidentially, and I / we agree to hold confidential the exact details of any tuition adjustment agreed upon.

Signature (1) _______________________________________Date _________________

Signature (2) _______________________________________Date _________________