Your Name: *


Your Email: *


Subject: *
Financial Aid Application

Street Address: *


State/Province: *


Country: *


Postal Code: *


Phone am: *


Phone pm: *


Fax:


Date Of Birth: *


SSN#: *


M/F: *
Male
Female

Are you currently employed?
Yes
No

1. Are you currently teaching yoga classes? *
Yes
No

1a. If so provide the location, days, times and fees you receive:


2. Are you a currently enrolled student of onlYoga? *
Yes
No

2a. If so, what is your current class package and expiration date?


3. What is your annual Adjusted Gross Income (as reported on last year's federal tax return)? *


3a. Year? *


4. If you did not file a tax return last year please expain the circumstances:


5. You can use the link below to attach other financial documentation:


6. Financial aid may be granted for any of the following reasons (use the drop down menus below to select any that apply): *
Not Applicable I am disabled and my sole income is SSI/disability/workers compensation benefits.

6a. *
Not Applicable I am a resident of a shelter, halfway house, transitional housing, Section 8 housing.

6b. *
Not Applicable I am unemployed and my sole income is unemployment benefits.

6c. *
Not Applicable I am the primary caregiver of a child under 5, with an annual family income less than $20,000.

6d. *
Not Applicable I am a full-time student below the age of 21 and reside in student housing or with parents.

6f. Other financial hardships - please describe:


7. I am applying for financial aid for (list workshop, course, class, training, or specific amount of aid - please specify): *


8. Please write a short essay (no more than 250 words) giving reasons for you application for aid and why it should be granted. *


9. I certify the information provided on this application is true, complete and accurately represents my financial status to the best of my knowledge. (Please note: Financial aid awards can be canceled for incomplete or innacurate information). *

10. Signature Required (please type your name): *


11. Date: *