Please report below all expected outside sources of financial assistance for the 2012-2013 academic year. Please be sure to indicate "yes" or "no" to each.

1. Tuition reimbursement from employer or spouse's employer? YesNo

Name of employer:
Amount per year:$

2.Veterans' benefits? YesNo


$ per month, for months during the 2012-2013 school year.

3. Any other resources, benefits or scholarships? (Please include anticipated state scholarships if you are not a resident of Massachusetts.) Yes No

Source: Amount: $

Source: Amount: $

4. Tuition Discounts:
Please check the appropriate answer for each question.

Are you a/an:
Sister of Notre Dame? Yes No
Clergyman of another religious order? Yes No
Boston Archdiocese school teacher?*Yes No
Boston Public school teacher?* Yes No
Nurse in a Catholic hospital?*Yes No
Employee of Blue Cross Blue Shield?* Yes No
Notre Dame Mission Volunteer/AmeriCorps ?* Yes No
New England Human Resources Assoc. Member ?* Yes No
City Year Corps, Staff, or Alumni ?* Yes No
*If you are employed by any of these organizations, please submit proof of employment (e.g., letter from supervisor).

Parking
If you are attending courses at the Boston campus there is a fee for parking.
Would you like financial aid to assist with the cost of parking?

Yes No

Optional: Please provide information regarding any special circumstances that might be helpful to us when assessing your financial need.