Download Fee Concession Application Form - Redeemer Lutheran ...

Fee Concession
Application Form
Please complete all sections.
Year in which Fee Concession is sought:
Name of Parent/Guardian:
Surname Christian Name Title
Surname Christian Name Title
Address:
Self
Spouse
Occupation:
Current employer:
Residence:
Do you own the dwelling where you reside? (please tick) Yes No
Are you paying rent? (please tick) Yes No
Self
Spouse
Details of income (per month): $ $
(a) Net take home pay (attach copy of current Pay Advice)
(b) Interest from banks and investments
(c)
Any other income: (e.g. Austudy, Family Allowance)
Total
Details of payments (per month):
(a) Mortgage/rent payments
(b) Car loan payments
(c)
Vehicle expenses
(d) Loan/credit cards repayments
(e) Insurances, rates, telephone and electricity
(f)
Medical, household and living expenses
(g) Education expenses (other institutions)
(h) Any other payments (please specify)
Total
Redeemer Lutheran College ABN 40 618 603 690
745 Rochedale Road, Rochedale Qld 4123 / PO Box 6090 Upper Mt Gravatt Qld 4122
Telephone: 07 3340 8888 Fax: 07 3340 8800 www.redeemer.com.au

Self
Spouse
Verification of annual income: $ $
Gross taxable income (annual) of previous tax year
(attach copy of Income Tax Return & Tax Office Notice of Assessment)
Assets: $ $
(a) Home value
(b) Property (shares, real estate etc.)
(c)
Cars, boat, caravan etc.
(d) Cash (investments, savings etc.)
Total
Liabilities:
(a) Home mortgage
(b) Property mortgages
(c)
Loans and credit cards
(d) Other (please specify)
Total
Children currently attending Redeemer:
Name
Year Level
Children for whom Fee Concession is sought:
Name Present School Year Level
Other dependent children not included above:
Name Age Name of School Currently Attended (if any)
Any other information which may assist in the consideration of your request:
Declaration: The answers given on this form are, to the best of my knowledge and belief, true and correct.
Date:
Your signature:
Your day time telephone number:
Spouse signature:
Redeemer Lutheran College ABN 40 618 603 690
745 Rochedale Road, Rochedale Qld 4123 / PO Box 6090 Upper Mt Gravatt Qld 4122
Telephone: 07 3340 8888 Fax: 07 3340 8800 www.redeemer.com.au