8/2/2019 2012-13 International Student Supplement - Continuing Student FORM

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INTERNATIONAL STUDENTFINANCIAL SUPPLEMENT This page should only be completed by international students. STUDENT INFORMATION 

Name:Last First Middle

Marital Status:Single/Divorced/Separated/Widowed Nationality:

Married/Remarried/Partnered Visa Status:

ANTICIPATED HOUSING ARRANGEMENT - Your response will help us estimate your expenses for 2012-13. This is not anapplication for on-campus housing and will not affect your housing status.  On Campus Off Campus Living with Parents

INCOME DATA – Do not leave any blanks. Convert all figures to U.S. Dollars. Rate of Exchange: $1 US =

Total gross income (before taxes) for 2011 for:You: $

Your Spouse: $

Total amount of your income tax for 2011 for:You: $

Your Spouse: $

Money received, or paid on your behalf, from sponsors, relatives other than parents, and trust funds: $

Total current balance of cash, checking, and savings accounts: $

Current net worth of investments (include trust funds; do not include primary residence or retirement funds): $

Current net worth of business, if you own a business: $

DEPENDENCY STATUS DETERMINATION 

Were you born before January 1, 1989? Yes No

Will you be working toward a graduate degree (i.e. MM, MFA, GD, etc.) in 2012-13? Yes No

Do you have children or dependents (other than a spouse) who receive more than half their support from you?If yes, how many?

Yes, ___ No

Are you an orphan (both parents deceased)? Yes No

PARENT INFORMATION 

Parents’ marital status: Married/Remarried/Partnered Single/Divorced/Separated/Widowed

How many people are in your parents’ household (including yourself)?

How many people in your parents’ household will be college students during the 2012-13 school year?

Parents’ dates of birth: / / and / / Month Day Year Month Day Year

 

INCOME DATA – Do not leave any blanks. Use the same rate of conversion noted in Student Information.

Parents’ total gross income (before taxes) for 2011:Parent 1: $

Parent 2: $

Total amount of your parents’ income tax for 2011:Parent 1: $

Parent 2: $

Total current balance of cash, checking, and savings accounts: $

Current net worth of investments (include trust funds; do not include primary residence or retirement funds): $Current net worth of business, if your parents own a business: $

VERIFY INFORMATION 

I certify that the information offered on this application is true and complete. I hereby give permission for The Juilliard School torequest any follow-up documentation as necessary, including tax transcripts from the IRS. I agree to notify the Office of FinancialAid promptly in writing if additional financial resources become available to me after filing this application. I understand that theOffice of Financial Aid reserves the right to adjust aid if necessary based on such resources.

Student Signature: Date:By typing your name, you agree to the terms listed above

Parent Signature: Date:Necessary only if information is required on page two