Special Circumstances Form - Academic Year 2020-2021

Section A. Student Information
Section B: Parents'/Stepparents' Information
Father/Stepfather
Mother/Stepmother

Section C: Request for Special Consideration based on Special Circumstances

1. Elementary/Secondary Tuition

If you will pay private elementary or secondary tuition in the 2020-21 school year for children in your household, please complete the following table. Specify both the school and grade for 2020-21 and the tuition costs and any assistance received for the 2019-20 year. You must provide a copy of your 2019-20 tuition bill as documentation* of this expense.

*All documentation must include the student's full name and Calvin ID number (if known) and may be sent to finaid@calvin.edu.
Student 1




Student 2




Student 3




Student 4




2. Reduction in Parental Income

If you have had a reduction in income of at least $10,000 since 2018 please explain in detail in the box below and complete the income projection questions. Please be specific, noting date of reduction and reason(s) for the reduction. You must submit documentation* of the income reduction (e.g. recent pay stubs, unemployment documents or letter of employment termination).

*All documentation must include the student's full name and Calvin ID number (if known) and may be sent to finaid@calvin.edu.

3. Other Extraordinary Expenses or Special Circumstances.

If you have other non-discretionary expenses or special circumstances (e.g. exceptional health care expenses, grandparent care expenses or higher than average cost of living expenses) please explain in detail below and provide documentation* (2 pages maximum) to substantiate the circumstances.

*All documentation must include the student's full name and Calvin ID number (if known) and may be sent to finaid@calvin.edu.