Form 035 PDF Details

The Form #035, also known as the Application Form for Diocese of Youngstown 2013-2014 Catholic School Scholarship Fund in Honor of Mary Ellen Cushwa Wolsonovich, serves a pivotal role for families seeking financial assistance for Catholic education. This comprehensive form requires applicants to provide detailed information about family dynamics, dependent information, and financial circumstances. It serves as a conduit for those in the Diocese of Youngstown area aiming to secure scholarship funds for one or more children within the household. The form mandates completion of all sections, including Parent Information, Family Information, and Dependent Information, emphasizing the importance of accuracy and thoroughness. Additionally, it stipulates the submission of a Private School Aid Service Student Aid Form alongside it in the same envelope for processing. The form’s design ensures that all relevant data is collected to assess the financial need accurately and allocate scholarship funds accordingly. By requiring such detailed information, along with parent or guardian verification through signatures, the form upholds a high standard of integrity in the scholarship application process. To be considered, applicants must meet the submission deadline, further highlighting the importance of timely and complete application packages.

QuestionAnswer
Form NameForm 035
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesMassillon, Ashtabula, Niles, 2013

Form Preview Example

Form #035

Form #035

Application Form for Diocese of Youngstown

2013-2014

Catholic School Scholarship Fund

In Honor of Mary Ellen Cushwa Wolsonovich

Instructions: Please complete every question on this application. Incomplete applications will be rejected. This form must accompany a Private School Aid Service Student Aid Form. Both forms must be sent to Private School Aid Service for processing in the same envelope.

Section 1 – Parent Information

_______________________

 

a. ParEnT or GuarDian

PariSh CoDE *

_____________________________________________________________________________

Last NameFirst NameMI

________________________ ______

________

_____________________

Social Security Number

Age

(Area Code)

Home Phone

________________________________________________________________________

AddressApt#

_____________________________________________________________________________

CityStateZip

___________________________________________

E-mail Address

Section 2 – Family Information

1.Number of family members who will reside in my/our household during the 2013-2014 school year:

Parents/Guardians ___________ Children ___________ Other* __________

*If other, please explain relationship to Parent _____________________________

 

_______________________

B. ParEnT or GuarDian

PariSh CoDE *

_____________________________________________________________________________

Last NameFirst NameMI

________________________ ______

________

_____________________

Social Security Number

Age

(Area Code)

Home Phone

________________________________________________________________________

AddressApt#

_____________________________________________________________________________

CityStateZip

___________________________________________

E-mail Address

2.Current marital status/housing arrangement of Parent/Guardian a:

a. o Single, never Married

d.

o Divorced*

g. o Residing w/Significant Other

b. o Married

e.

o Divorced/remarried*

h. o Other: _______________

c. o Widowed

f.

o Separated*

_______________________

Section 3 – Dependent Information

Please list all dependents in order, youngest to oldest, including college students.

 

 

 

 

Grade in

Name of school student plans to enter

Amount I/We

Tuition

 

Dependent

Dependent

 

 

in the Fall of 2013

School

 

 

feel I/We can

M.I.

Age

the fall

charged yearly

(PLEASE DO NOT ABBREVIATE)

Last Name

First Name

 

 

 

pay toward

 

Code*

 

 

 

 

of 2013

City and State

tuition?

per student?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

School Name

 

 

 

 

 

 

 

City and State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

School Name

 

 

 

 

 

 

 

City and State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

School Name

 

 

 

 

 

 

 

City and State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

School Name

 

 

 

 

 

 

 

City and State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* Refer to School / Parish Code list.

Section 4 – Parent Sign Off and Verification

I/We declare that the information on this form is true, correct and complete, to the best of my/our knowledge. I/We authorize Private School Aid Service to return this form and any relevant attachment to the Diocese of Youngstown.

Parent or Guardian Signature (Parent A):

__________________________________________________________________________

Date Completed _________________

Parent or Guardian Signature (Parent B):

__________________________________________________________________________

Date Completed _________________

To be considered for the Youngstown Diocesan Scholarship Fund, in honor of Mary Ellen Cushwa Wolsonovich, please submit this application before MarCh 15, 2013.

DIOCESE OF YOUNGSTOWN SCHOOL AND PARISH CODE LIST

List School Code Number in Section 3 List Parish Code Number in Section 1 - A & B

School Code

School name

City

1891

Regina Coeli

Alliance

1243

St. John School

Ashtabula

4959

St. Joseph and Immaculate

 

 

Heart of Mary School

Austintown

2232

St. Charles

Boardman

2233

St. Luke

Boardman

2234

St. Joseph the Provider

Campbell

1459

SS. Philip & James School

Canal Fulton

1126

Canton Central Catholic High School

Canton

1151

Our Lady of Peace

Canton

2237

St. Joan of Arc

Canton

2238

St. Joseph

Canton

4953

St. Michael

Canton

2240

St. Peter

Canton

2222

St. Aloysius

East Liverpool

2174

Assumption

Geneva

2212

St. Rose

Girard

1443

St. Patrick School

Hubbard

2219

St. Patrick

Kent

2243

St. Louis

Louisville

1084

St. Thomas Aquinas High School

Louisville

1104

St. Joseph School

Mantua

2244

St. Barbara

Massillon

2245

St. Mary

Massillon

2214

St. Stephen

Niles

1489

St. Paul Catholic School

North Canton

1410

Holy Family School

Poland

2220

St. Joseph

Randolph

1814

St. Paul

Salem

2236

St. Nicholas

Struthers

1998

John F. Kennedy High School

Warren

2211

St. James

Waynesburg

1094

Cardinal Mooney High School

Youngstown

1288

St. Christine School

Youngstown

2225

Ursuline

Youngstown

Parish Code

Parish name

City

5190

Regina Coeli

Alliance

5189

St. Joseph

Alliance

5103

Our Lady of Victory

Andover

5104

Mother of Sorrows

Ashtabula

5105

Our Lady of Mt. Carmel

Ashtabula

5106

St. Joseph

Ashtabula

5114

Our Lady of Perpetual Help

Aurora

5191

St. Therese

Brewster

5124

St. Elizabeth

Campbell

5127

St. John the Baptist

Campbell

5125

St. Joseph the Provider

Campbell

5126

St. Lucy

Campbell

5192

SS. Philip and James

Canal Fulton

5128

St. Michael

Canfield

5207

All Saints

Canton

5214

Our Lady of Peace

Canton

5208

Sacred Heart of Jesus

Canton

5210

St. Anthony

Canton

5209

St. Benedict

Canton

5213

St. Joan of Arc

Canton

5205

St. John the Baptist

Canton

5212

St. Joseph

Canton

5211

St. Mary

Canton

5215

St. Michael

Canton

5206

St. Paul

Canton

5204

St. Peter

Canton

5129

St. Jude

Columbiana

5107

St. Frances Cabrini

Conneaut

5108

St. Mary

Conneaut

5130

St. Robert

Cortland

5101

St. Aloysius

East Liverpool

5100

St. Ann

East Liverpool

5131

Our Lady of Lourdes

East Palestine

5115

St. Ambrose

Garrettsville

5109

Assumption

Geneva

5132

St. Rose

Girard

5134

St. John the Evangelist

Hanoverton

5133

St. Patrick

Hanoverton

5135

St. Philip Neri

Hanoverton

5136

St. Patrick

Hubbard

5110

St. Joseph

Jefferson

5117

Kent Newman Center

Kent

5116

St. Patrick

Kent

5111

St. Andrew

Kingsville

5137

St. Patrick

Kinsman

5138

St. Catherine

Lake Milton

5139

St. Patrick

Leetonia

5140

St. George

Lisbon

5194

Sacred Heart of Mary

Louisville

5193

St. Louis

Louisville

5141

Our Lady of the Holy Rosary

Lowellville

5119

St. Joseph

Mantua

5198

St. Barbara

Massillon

5197

St. Joseph

Massillon

5196

St. Mary

Massillon

5143

St. Bernadette

Masury

5199

St. Joseph

Maximo

5142

Our Lady of Perpetual Help

McDonald

5145

St. Paul the Apostle

New Middeltown

5144

St. Mary

Mineral Ridge

Parish Code

Parish name

City

5120

St. Joseph

Mogadore

5200

St. Clement

Navarre

5146

St. Joseph

Newton Falls

5147

St. Mary

Newton Falls

5149

Our Lady of Mt. Carmel

Niles

5148

St. Stephen

Niles

5217

Little Flower

North Canton

5216

St. Paul

North Canton

5150

St. James

North Jackson

5112

St. Mary

Orwell

5186

Holy Family

Poland

5121

Immaculate Conception

Ravenna

5113

Sacred Heart

Rock Creek

5122

St. Peter of the Fields

Rootstown

5151

St. Paul

Salem

5201

St. Ann

Sebring

5118

St. Joan of Arc

Streetsboro

5153

Holy Trinity

Struthers

5152

St. Nicholas

Struthers

5202

Holy Spirit

Uniontown

5155

Queen of the Holy Rosary

Vienna

5154

St. Vincent de Paul

Vienna

5158

Blessed Sacrament

Warren

5163

Christ our King

Warren

5160

SS. Cyril & Methodius

Warren

5161

St. James

Warren

5159

St. Joseph

Warren

5156

St. Mary

Warren

5162

St. Pius X

Warren

5157

St. William

Warren

5203

St. James

Waynesburg

5102

Immaculate Conception

Wellsville

5164

St. Agatha

West Point

5123

St. Michael

Windham

5177

Holy Name

Youngstown

5171

Immaculate Conception

Youngstown

5187

Immaculate Heart of Mary

Youngstown

5178

Our Lady of Hungary

Youngstown

5169

Our Lady of Mt. Carmel

Youngstown

5173

Sacred Heart

Youngstown

5167

SS. Cyril & Methodius

Youngstown

5182

SS. Peter and Paul

Youngstown

5180

St. Anthony

Youngstown

5179

St. Brendan

Youngstown

5181

St. Casimir

Youngstown

5185

St. Charles

Youngstown

5183

St. Christine

Youngstown

5166

St. Columba

Youngstown

5176

St. Dominic

Youngstown

5168

St. Edward

Youngstown

5188

St. Joseph

Youngstown

5184

St. Luke

Youngstown

5165

St. Matthias

Youngstown

5174

St. Patrick

Youngstown

5170

St. Rose of Lima

Youngstown

5175

St. Stanislaus

Youngstown

5172

St. Stephen

Youngstown

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