Financial Aid Review Form

Le Moyne College strives to offer families the best financial aid package possible. We will consider additional financial aid requests if there are special circumstances which are not reflected on the FAFSA.

Please complete the FAFSA at https://fafsa.gov before submitting this form.

I am a...

Student

Parent

Parent Information

Relationship to student

Parent First Name

Parent Last Name

Parent Email Address

Parent Phone

Best way and time to contact you

Student Information

Student First Name

Student Last Name

Student Email Address

Student Birthdate

Best way and time to contact you

Are you a current student or an incoming student?

Incoming (planning to attend)

Current student (already attending)

Financial Aid Review

Reason(s) for Review: (Please check all that apply)

Loss/Change of Job: Please type below your estimate 2024 income including wages, severance pay, unemployment income, pensions. business income, alimony and child support.

Separation or divorce: Provide below the date parents either separated or divorced and the 2023 income of the custodial parent.

Death of a parent: Provide below Parent name and date of death.

Medical and dental expenses: Provide an estimate of expenses paid in 2022.

Private elementary and secondary tuition: Provide below elementary and high school tuition expenses for 2023/24.

Merit scholarship: Provide explanation below.

Other: Please provide below any additional information you wish the Financial Aid Office to consider.

In the box below, please provide any requested information listed above for all circumstances that you have indicated.

Upload Supporting Documents

Do you have any supporting documentation that you would like to upload for our review?

Yes

No

Optional: Please upload any supporting documentation regarding your special circumstance.