Spreadsheet: 07836723-2930-40a5-958d-23bd018bd209
Sheet: Sheet1

Needy Student's Fund - Budget Request Form |  | Version 1.0
Please save and return information in Excel format
Section A - Biographical Data
[NAME] | Information | Comments
Date of Request
Name of Student
Name(s) of dependents and age
Street Name and Number
City/Town
Province
Postal Code
Phone Number
Name of church where applicant is a member
Name of church where applicant was a member prior to entering [NAME] (if applicable)
Has applicant been officially accepted by the [NAME]?
Which study year will applicant enter in the coming year at the [NAME]?
Section B - Calculating Your Requested Need
Regular Expenses: | Monthly Amount | Comments
Church/Charitable Donations
Christian School Tuition
Mortgage or Rent
House/Property Maintenance
Heat/Hydro/Water
Telephone/Internet
Property Taxes
Furnishings/Appliances
Groceries
Personal and Health Care expenses
Clothing and Footwear
Vehicle payments
Vehicle maintenance
Gas
Insurance (vehicle)
Insurance (home)
Insurance (personal)
Children's supplies
Entertainment
[NAME]. |  | Allowance of $10/person for [NAME]. expenses per month
Other expenses (list):
Sub-Total
Fixed / Annual Expenses: | Annual Amount | Comments
Curriculum Costs (Tuition, books, supplies, etc.)
Other Fixed / Annual Expenses (list):
Sub-Total
Pre-Study Period Earnings¹: | Annual Amount | Comments
Total Net Income (post-government deductions)
Unemployment Insurance or Other Benefits
Other net Income/Earnings
Sub-Total
Pre-Study Period Expenses¹: | Annual Amount | Comments
Total Expenses for the Pre-Study Period
Sub-Total (Pre-Study Period Savings available each month) |  | Total reflects net pre-study period earnings and is converted to a monthly amount for each month in the study period (9)
Monthly Study Period Earnings² | Monthly Amount | Comments
Part Time Earnings
Spousal Earnings
Support from Parents/Relatives
Regular Government Benefits (baby bonus etc.)
Sub Total (monthly Study Period Earnings)
Monthly Study Period Earnings² | SUM Total | Comments
Income Tax Refund (expected)
Other earnings (scholarships, etc.)
Sub-Total (annual/one-time Study Period Earnings) |  | Amount reflects conversion of total sum divided over each month in the study period (9).
Fixed Assets | SUM Total | Comments
Bonds, Stocks, Bank Savings, etc. (List):
Home Equity
Vehicle value (if above $5000)
Other
Sub-Total |  | Assessed independently of all other expenses/revenues on a case-by-case basis (reference Sec. 1.2 of the Guidelines)
Section C - Summary
Total Monthly Resources (available earnings from the Pre-Study Period excl. fixed assets/savings) |  | *If number is negative, subtract this number from the "Total Monthly Request" line.  Fund does not finance shortfalls in Pre-Study Period (reference Sec. 2.6 of the Guidelines)
Total Monthly Net Revenues: (Study Period)
Total Monthly Expenses (Study Period)
TOTAL MONTHLY REQUEST (Resources + Revenues + Fixed Assets (as determined) - Expenses |  | Negative number refers to monthly shortfall; requested amount per month.
¹Earnings for 3 month period prior to entering new school year (June/July/August)
²Earnings for the school study period (September 1 - May 31)