Application for Financial Assistance

Step 1 of 5

Anyone wishing to be considered for a scholarship or reduction in tuition must complete this form. All questions should be answered using the currency in which they were paid or received. Please note if currency is not US$.

Student Information

Student’s First Name(Required)

Student’s Last Name(Required)

Does the student have a bachelor’s degree?(Required)

From which institution?(Required)

Is the student a United States citizen or resident?(Required)

What is the visa status?

Add an additional NIRC Student

Add NIRC Student

Student’s First Name(Required)

Student’s Last Name(Required)

Does the student have a bachelor’s degree?(Required)

From which institution?

Is the student a United States citizen or resident?(Required)

What is the visa status?

Student’s First Name(Required)

Student’s Last Name(Required)

Does the student have a bachelor’s degree?(Required)

From which institution?

Is the student a United States citizen or resident?(Required)

What is the visa status?

Student’s First Name(Required)

Student’s Last Name(Required)

Does the student have a bachelor’s degree?(Required)

From which institution?

Is the student a United States citizen or resident?(Required)

What is the visa status?

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does/Do student(s) live with both parents?(Required)

Please explain(Required)

Parent information

Name of Father or Guardian(Required)

Father's Age(Required)

Name of Mother or Guardian(Required)

Mother's Age(Required)

Address (if different than above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address (if different than above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Father's Job Description/Title(Required)

Mother's Job Description/Title(Required)

Father's Employer's Name(Required)

Mother's Employer's Name(Required)

Father's Email Address(Required)

Mother's Email Address(Required)

Father's Cell Phone(Required)

Mother's Cell Phone(Required)

Family Information
Please list all unmarried children in the family (including those coming to NIRC):

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

Add Child

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

First Name

Age

Does the child live with parent(s)?

School or Occupation (2024-2025)

Amount paid by parents for tuition (2024-2025).

Does it includes room and board?

Anticipated School / Occupation (2025-2026).

Estimated tuition for 2025-2026

Application for Financial Assistance

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Address

Contact

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