Special Circumstances Worksheet

If applicable

Changes in Income

If your parents were recently divorced or separated, but filed a joint 2017 tax return, please provide the following items:

  • Parents' 2018 federal tax form (1040, 1040A, or 1040EZ)
  • Divorce decree including settlement agreement
  • Non-Custodial parent information

Non-Custodial parent information

Extreme Medical or Dental Expenses

If your family has incurred medical/dental expenses in 2017 that in total will likely exceed of 10% of your household income, please forward the following:

  • Parents' completed 2018 federal tax form (1040, 1040A or 1040EZ), including schedule "A."

Other Special Circumstances

Verification

We cannot process your worksheet without your verification below.

We certify all the information provided to be correct and accurate. We also understand that if the projected circumstances fail to materialize, any financial assistance received because of the conditions is subject to rescission on this or subsequent academic years.