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Financial Assistance Form
Which online education course are you seeking financial assistance for?
The Franciscan Way (Oct. 25 - Dec. 12, 2023)
Which program are you seeking financial assistance for?
The Divine Exchange (June 12 - Sept. 17, 2024)
Online Education Course Information
Scholarships for Online Education Courses are not currently available. Please visit our
course catalog
for course dates and information. Scholarship applications will open at the same time as registration.
Were you required to file a U.S. federal tax return this past year?
Please select...
Yes
No
Please explain why you weren't required to file a U.S. federal tax return:
Please select...
Member of a religious order
I do not live within the U.S. and filed my taxes in another country
Other
If "other", please elaborate here:
Please select the correct range for your "adjusted gross income" from your most recent U.S. federal tax return (e.g., line 7 on form 1040).
Please select...
Under $10,000
$10,000 to less than $20,000
$20,000 to less than $35,000
$35,000 to less than $50,000
$50,000 to less than $75,000
$75,000 to less than $100,000
$100,000 or more
Please convert your annual income to United States Dollars (USD) and then select the correct range from the dropdown menu below.
Please select...
Under $10,000
$10,000 to less than $20,000
$20,000 to less than $35,000
$35,000 to less than $50,000
$50,000 to less than $75,000
$75,000 to less than $100,000
$100,000 or more
How many dependents are listed on your tax return?
Please select...
0
1
2
3
4
5
6
7
8
9
10
Is there anyone else to whom you are providing any support that draws on your financial resources? If so, please briefly describe your situation.
Are you a currently enrolled student?
Please select...
No
Yes
STUDENT INFORMATION
Where are you enrolled as a student? (e.g. college, university, seminary, etc)
Please select...
2 - Year College
4 - Year University
Seminary
Living School Student
Trade School
Area of Study
Please select...
Business
Communication
Design
Education
Engineering
Formal Sciences
Health Sciences
Mathematics
Medicine
Natural Sciences
Philosophy
Natural Sciences
Sociology
Other
Business
Communication
Design
Education
Engineering
Formal Sciences
Health Sciences
Humanities & Social Sciences
Mathematics
Medicine
Philosophy
Sociology
Other
Divinity
Humanities & Social Sciences
Ministry Ethics
Religion
Religious History
Theology
Youth Ministry
Other
Current Student
Alumni
Other
Accounting
Allied Health Career
Computer Science
Communication and Media
Health Information Management
Law Enforcement
Other
If "Other", please specify:
What is the name of the institution where you are currently enrolled?
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Please respond thoughtfully to the following questions. This information helps CAC be consistent when we consider financial assistance requests for all individuals who cannot afford CAC’s programs on their own. This ensures that we are spending funds where they are really needed, something that is important to the generous donors who make these funds available. Information you provide will be kept confidential.
First Name
Last Name
Email
Phone
Date of Birth
MM/DD/YYYY
Gender
Please select...
Female
Male
Transgender
Other
Race
Please select...
American Indian to Native Alaskan
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Two or more races
Ethnicity
Please select...
Hispanic/Latino/Spanish Origin
Not Hispanic/Latino/Spanish Origin
Primary Religious Affiliation
Please select...
12-Step Spirituality
African Tradition
Agnostic Atheist
Baha'i
Buddhism
Chinese Tradition
Christianity - Anabaptist
Christianity - Anglican
Christianity - Baptist
Christianity - Catholic
Christianity - Episcopal
Christianity - Evangelical
Christianity - Lutheran
Christianity - Mainline Protestant
Christianity - Methodist
Christianity - non-denominational
Christianity - no specification
Christianity - other
Christianity - Presbyterian
Hinduism
indigenous
interfaith
interspiritual
Islam
Judaism
Native American
Nonreligious Secular
Sikhism
Spiritualism
Unitarian Universalism
Wiccan Pagan Druid
Other
Other
Country
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Street Address Line 1
Street Address Line 2
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Provinces
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State/Province
Postal Code
Page 3 of 3
FINANCIAL ASSISTANCE REQUESTED
The full tuition/registration cost of the program for which you are seeking assistance is:
$
Please enter the amount you are able to contribute:
$
Please enter only numbers with no special characters.
The amount of financial assistance you are requesting is:
$
ADDITIONAL QUESTIONS
Is there any event that has occurred in the last three (3) years of your life that has placed a significant strain on your financial resources? If so, please briefly describe your situation.
Have you explored a potential contribution from other sources, including your church or employer?
Please select...
Yes
No
Please tell us more about the other sources from which you've explored potential contributions.
Why do you want to participate in this program? How do you hope to integrate your experience in this program within your personal life and/or vocation?
Please add any other comments that would assist us in evaluating your request for financial assistance:
Contact Information