A. general information

Family Number*

Name*

Year Applying

Marital Status*

Married

Separated

Divorced

Other

Address*

Phone*

People in your family?*

B. tuition

List Children Under 19 years of age attending fee paying school-begin with eldest

In ASD? Name Age School ASD ID Grade Tuition (AED)

Total Tuition (Including other K-12 School) (AED)

Total ASD portion of this tuition (AED)

C. Assistance

Amount you seeking in assistance from ASD? (AED)

Are you self-employed?

Yes

No

Have you sought assistance from family members/friends or other sources?

Yes

No

Have you sought assistance from ASD in the past?

Yes

No

Assistance Before Year

D. Net Worth Statement

VALUE (AED) DEBT (AED) MO.PAYMENT (AED)

House

Other RealEstate

Vehicle Year/Make

Business Investment

Savings

Investments

Annuities

Recreational Equipment

Cash

Credit Card Debt

Personal Debt or Line of Credit

Other

Total (AED)

Total Net Worth (AED)

E. Income

EMPLOYER/SOURCE ANNUAL (AED)

Employment Income - Father

Employment Income - Mother

Business Income

Commission Income

Other Income

Rental Income

Alimony/Child Maintenance

Other(including income from family members)

Employer Eductional Benefit

TOTAL INCOME (AED)

F. Expenses

MONTHLY AMOUNT (AED) ANNUAL AMOUNT (AED)

Rent

Mortgage Payment

Activities

Vehicle Payments

Auto Insurance

Gas and Vehicle Maintenance

Utilities

Telephone

Cable

Medical/Dental

Groceries

Entertainment

Vacations

Charitable Donations

Credit Card Payments

Personal Loan Payments

Savings Deductions

Other

TOTAL EXPENSES (AED)

Are charge cards normally paid in full each month?

Yes

No

G. Special Circumstances

Please provide details as to your circumstances so that we can better understand your family's financial need.Be sure to include details as to any changes in benefits, salary, or employment.

*

H. Supporting Documentation

In order for us to process your application, the following documents must be attached for both mother and father:

All files should be Images or PDF.

3 months of bank statements for all bank statements and investments accounts including the account from which your tuition has been paid in the past.

For US Citizens, copies of tax return field for the most recent tax year.

Salary certificate or employment contract.

Rental contract, if applicable.

Change in benifits letter from employer (ie. salary reduction, educational benefits reduction, change in employment, etc)