+ All Categories
Home > Documents > FINANCIAL AID APPLICATION Islamic Center of Frisco (ICF) … · Islamic Center of Frisco (ICF)...

FINANCIAL AID APPLICATION Islamic Center of Frisco (ICF) … · Islamic Center of Frisco (ICF)...

Date post: 16-Mar-2019
Category:
Upload: dophuc
View: 215 times
Download: 0 times
Share this document with a friend
4
11137 Frisco St, Frisco, TX 75033 Phone:(469) 252-4532 email: [email protected] FINANCIAL AID APPLICATION Islamic Center of Frisco (ICF) Community Assistance Program (CAP) Islamic Center of Frisco Along with the application please provide all documents that support your case, such as but not limited to: • 3 Months bank statement (that shows your daily transaction, such as salary, bills, payments, housing payments, etc...) • Job letter with salary information. • If layed off, proper lay-off paper work from last Work place. • Utility Bills (Water, Gas, Electric,Internet). • Lease/Rental Papers, copy of first 2-4 pages where lease and terms are discussed. • Drivers License. • Marriage/ Divorce Cert. • 2 References from your local Masjid's Imam or Shura members if available. • Any other supporting documents to establish identity and monthly expenses. Thank you May Allah bless you with best of Dunia and Akhira... Page 1 of 4 www.friscomasjid.org Applicant acknowledges and understands that ICF must follow strict guidelines in allocation of these funds. As such, Applicant understands and consents to sharing relevant medical and financial information in order for ICF to determine eligibility. This information shall be kept confidential subject to applicable law and ICF policy. A background check may also be required. Applicant consents to providing any information so that ICF may perform a background check and due diligence of Applicant's eligibility to receive benefits.
Transcript

11137 Frisco St, Frisco, TX 75033Phone:(469) 252-4532

email: [email protected]

FINANCIAL AID APPLICATIONIslamic Center of Frisco (ICF) Community Assistance Program (CAP)

Is lamic Center of Fr isco

Along with the application please provide all documents that support your case, such as

but not limited to:

• 3 Months bank statement (that shows your daily transaction, such as salary, bills, payments,

housing payments, etc...)

• Job letter with salary information.

• If layed off, proper lay-off paper work from last Work place.

• Utility Bills (Water, Gas, Electric,Internet).

• Lease/Rental Papers, copy of first 2-4 pages where lease and terms are discussed.

• Drivers License.

• Marriage/ Divorce Cert.

• 2 References from your local Masjid's Imam or Shura members if available.

• Any other supporting documents to establish identity and monthly expenses.

Thank you

May Allah bless you with best of Dunia and Akhira...

Page 1 of 4www.fr iscomasj id.org

Applicant acknowledges and understands that ICF must follow strict guidelines in allocation of these funds. As such, Applicant understands and consents to sharing relevant medical and financial information in order for ICF to determine eligibility. This information shall be kept confidential subject to applicable law and ICF policy. A background check may also be required. Applicant consents to providing any information so that ICF may perform a background check and due diligence of Applicant's eligibility to receive benefits.

Is lamic Center of Fr iscoPage 2 of 4www.fr iscomasj id.org

Date:

(Application must be filled out completely to be processed)

Applicant’s Name:

First:

Gender: M F

Last:

Married Single Divorced Widowed

Spouse Name: First:

Number of Childern: Age(s):

Last:

Current Address:

Address Line 1:

City: State: Zip Code:

Address Line 2:

Home Phone: ( ) - Mobile: ( ) -

Email Address:

Driver License or State Issued ID Number: State Issued:

* A copy of the driving license or a valid picture ID needs to be attached to the application.

Yes No If No: How long has been out of employment:

Employment:

Currently Employed:

Address:

Current or Former Employer: Monthly Income:

Work Phone: ( ) -

State: Zip Code:City: Position:

FINANCIAL AID APPLICATION

Is lamic Center of Fr iscoPage 3 of 4www.fr iscomasj id.org

References:

First: Last:

Relationship to Applicant:Have Known since:

Phone Number: ( ) -

First: Last:

Relationship to Applicant:Have Known since:

Phone Number: ( ) -

Reason (s) for Financial aid request: (Please check all that apply)

Utilities bill (Electric/Gas/Water): (Please provide company name, address and account number. Attach copy of bill)

Rent: (Please provide Landlord’s name, address and Apt# and amount due. Attach any notices)

Food: (Other than monetary assistance, if you also need help with food or other items, please describe your needs below)

Other: (Please describe what your specific needs are if it is not Utilities, Rent, or Food)

When:

Have you applied for financial assistances at any other organization:

Yes

If Yes, Name of the organization:

No

FINANCIAL AID APPLICATION

Is lamic Center of Fr iscoPage 4 of 4www.fr iscomasj id.org

(Note: All or some information on this form may be shared with other Masajids/Charity Organizations)

Additional Information:

Please use the space below to provide additional information that might help us to evaluate and to understand yourfinancial needs. (Attach separate sheet if necessary)

Concerns:

I, , authorize ICF to contact other organization(s) or the references

listed on this application to verifty the information provided and to obtain additional information.

Applicant’s Signature: Date:

Application will not be processed unless signed by the Applicant.

For ICF Use Only:

Application Processed By: Date:

Amount Approved:

Check Payable to:

Additional Notes for the ICF Treasure/CAP Chair Person:

FINANCIAL AID APPLICATION


Recommended