Financial Aid Application Form

Click here to view or download a form for a Leadership Cattaraugus Tuition Discount Application.

CONFIDENTIAL
APPLICATION FOR TUITION DISCOUNT
Leadership Cattaraugus

A limited number of PARTIAL tuition discounts are available to assist members of a Leadership Cattaraugus Class who demonstrate financial need. Maximum tuition discount available from Leadership Cattaraugus is $400.00 per participant. Discount decisions will be made by the Financial Aid Committee after the class has been selected.

To request a tuition discount, complete the form below in its entirety and submit it WITH your application.

Incomplete tuition discount forms will NOT be considered. Questions must be answered in full.

Please enter all appropriate information:

NAME
TITLE
ORGANIZATION
ADDRESS
PHONE
EMAIL

Amount of tuition discount you are requesting:

(Maximum is $400)

Please place a check in the type of organization you represent:

	Small Business
	Ordained Clergy
	Education
	Government
	501-C-3 Organization (please note: Arts, Human Services, Health Care, etc.
	Other (please specify):

List your company/organization’s total annual income for your most recent fiscal year:

Indicate your projected gross family income for the participating year:

$0-$30,000

$30,001-$50,000

$50,001-$75,000

Over $75,000

Number of people your family income is supporting:

List any major or unusual expenses your family is facing in the participating year. Please note general dollar amounts (eg. 3 college tuitions + books at MIT = $95,000. / new roof = $950. / major car repairs = $1,200.)

What other sources of tuition assistance are you exploring / have you secured?

Funds for tuition discounts are limited. A number of requests are received each year. Please explain why YOU should be awarded a discount.

I certify that the above information is true:

Initials of Candidate

Forward this form to:
Leadership Cattaraugus
P.O. Box 176
Olean, NY 14760