EOS Program Supplemental Information
Student’s Name: ______
LastFirst
Drew ID #:______
Please complete this form and return it to the Educational Opportunity Scholars Office. If you have questions about the form, please contact us at 973-408-3578 or .
PLEase circle One
- Doyou/yourparentsownother realestateother than your primary residence? YES NO
* If yes, please attach all pages of schedule E from your parent 2016 Federal Tax Return.
Ifyes, what is the current market value of the real estate?
What was the purchase price of the real estate?
What is currently owed on the real estate?
2.Doyouoryourparentsownabusiness? YESNO
* If yes, please attach all pages of schedule C, C-EZ and/or E from your parent 2016 Federal Tax Return.
Ifyes,how many full time employees are there? ______
What is the current market value of the business?_
What debt is currently owed on the business?
3.Please list the current value of all of the following:
Checking and Savings Accounts:StudentParent
Investments:(Do not include
designated retirement funds)StudentParent
4.Are you eligible for Veterans’ educational benefits for 2018-2019?YESNO
If yes, what is the monthly amount?
5. Did you/your family receive TANF or welfare? 2016: YESNO
2017: YESNO
7. In 2016 did you receive free or reduced lunch benefits? YESNO
8.Do you have siblings who are/were EOF students?YESNO
If yes, what institution do/did they attend?______
(over)
Applicant and parent(s) signatures are required below to certify all information contained in this document. Without both signatures, your application is not complete and cannot be processed. By submitting this form, I/We certify that this application, including supporting credentials and documents, is complete, factually correct, and honestly prepared. I/We agree to provide, if requested, any other documentation necessary to verify the information reported.
I understand that if I am accepted into theEOS Program at Drew University, I must complete the mandatory five week summer program prior to the fall semester. Please check the box to confirm.
Parent 1 Signature: ______Date: ______
Parent 2 Signature: ______Date: ______
Student’s Signature: ______Date: ______
Please submit this form via mail, FAX or email to:
Drew University Educational Opportunity Scholars Office
36 Madison Avenue, Rose Memorial Library, Suite 59
Madison, NJ 07940
973-408-3463 (FAX)