Please print this form and send via mail along
with your completed Transcript Request & Recommendation
Form and transcript to: Caldwell College Office of Admissions
9 Ryerson Avenue • Caldwell, New Jersey 07006
973-618-3500 • Toll Free 1-888-864-9516 • Fax: 973-618-3650
PART I: PERSONAL DATA (Please type
or print clearly)
Male / Female (Please
Circle One)
Name:
Last
First
Middle/Maiden
Date of Birth
Permanent Address:
Street
City
State
Zip
County
Home Telephone No.: ( )
Social Security Number: (for
ID. purposes only)
Are
you a U.S. Citizen?
Yes
No
Marital status:
Single
Married
Separated
Divorced
Permanent
Resident?
Yes
No If
Yes, give Registration No.
Parent's Current
Marital Status:
Single
Married
Separated
Divorced
Housing while
attending Caldwell College:
Resident
(Living on campus)
Commuter
(Living in parents'
or relatives' home)
Off-campus residence
(Living in off-campus accommodations)
No. of dependent
family members in household (including parents): No.
of siblings who will be enrolled (including yourself) in college at
least half-time the next academic year:
Age of oldest parent:
State of legal residence:
Relatives who have graduated from Caldwell College:
PART II: EDUCATIONAL DATA
Check the appropriate enrollment status:
1st Time Freshman
Transfer Student
International
If you are a transfer student, indicate your academic
level:
Freshman
Sophomore
Junior
Senior
Intended Major: _______________________
Have you ever attended any colleges, university or post-secondary
schools?
Yes
No
If you checked "yes" please write in the space below the
name of the institution, dates attended and degrees earned, if any.
Did you receive
any financial assistance at any of these colleges?
Yes
No
FINANCIAL INFORMATION: APPLICANTS SEEKING
NEED-BASED AID If you would like a comprehensive
estimate of all sources of financial assistance which may be available to
you, including federal and state need-based aid, please be sure to fill
in the information requested below. When you supply this information we
will mail a preliminary financial aid award notification to you, following
your admissions acceptance letter.
INCOME
INFORMATION: In completing this section,
use your last year's Federal Income Tax Returns, and your most recent
payroll statements to estimate your income and taxes. Please make
sure to separate the student's information from the parents'.
Sources of Tax Return Figures: Check
whether you expect to file a Form 1040A or EZ, a Form 1040, or
no tax return.
Federal Income Taxes Paid: Make
sure you estimate the total federal Tax Owed as reported on the
tax return, and not the amount withheld as reported on W-2 or
1099 forms.
Wages Earned: Separate the Father's and
the Mother's earnings, even though they may file a joint return.
Social Security Benefits, AFDC/ADC, and Annual
Child Support: Make sure to list annual, not
monthly amounts.
STUDENT
PARENT
Number
of Exemptions
Sources
of Tax Return Figures:
1040A
or EZ
1040
Tax
return will not be filed
Adjusted
Gross Income
Federal
Income Taxes Paid
Wages
Earned
Father
Mother
Annual
Social Security Benefits
Annual
AFDC/ADC (Welfare)
Annual
Child Support Received
Other
Untaxed Income (such as monies to pension plans)
ASSET INFORMATION (Net
Value is the value of the asset minus any debt on that asset):
Cash Include all checking and savings
accounts.
Real Estate Do not include the primary
family residence. Do include rental property, land, second or
summer homes, and multi-family dwellings (except the part your
family lives in).
Investments: Include stocks, bonds, mutual
funds, certificates of deposit and other securities. DO NOT INCLUDE
tax-sheltered holdings such as IRA, 401(K), 403(B), or other pension
plans. But you should report any monies that may go towards these
plans this calendar year under Other Untaxed Income above.
STUDENT'S
ASSETS
PARENT'S
ASSETS
Net Value
Net Value
Cash
Real
Estate (Other than primary residence)
Investments
Business
Farm
This form is designed to determine estimated
Financial Aid eligibility, using a minimum amount of unverified
information and assumptions. If your circumstances are unusual,
please explain on a separate sheet and attach to this form.
I understand that after completion of this form,
I will receive an early estimate of my eligibility
for aid. I further understand that I must also be accepted for admission
and complete the Free Application for Federal Student Aid (FAFSA)
in order to finalize a Financial Aid Award. I understand that estimated
aid is always subject to change upon review of the FAFSA and current
Tax forms, verification of untaxed income and availability of funding.
