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FLBC Sponsored Financial Aid Application

For new and returning students
You must be an accepted student at FLBC to be considered for FLBC sponsored financial aid.
No information is shared with any government entity. Personal financial data is kept confidential and is only viewed by FLBC financial aid administrators.
FLBC has no involvement with FAFSA and does not accept FAFSA awards
For clarification on terms and requirements visit StudentAid.gov
The final deadline to submit a financial aid application for the 23-24 academic year is July 30, 2023

Aid application for school year:(Required)

2023-24 – Incoming Student

2023-24 – Returning Student

Student Name(Required)

First Last

Student Email(Required)

Student Mobile Phone(Required)

Student Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Church name and affiliation(Required)

Financial assistance from church(Required)Enter any financial help you expect to receive from your church during the 2023-24 school year. Enter $0 if you church does not give financial assistance.

Student dependency status(Required)Students who are under 24 (as of 12/31/2023) and unmarried are typically considered dependent. An independent student must meet at least one of the following criteria:

Born before January 1, 2000
Currently married
A veteran of the US armed forces or currently serving on active duty for purposes other than training
Has legal dependents other than a spouse
An emancipated minor or in legal guardianship
A homeless student
A student for whom an FLBC financial aid administrator makes a documented determination of independence

Household Information

State of residence(Required)Or U.S Territory

Number of people living in the student's household (including the student)(Required)

Number of household members in college(Required)Include the student but do not include parents. Do not include those enrolled less than half time.

Parent Information

Number of parents in the household(Required)

One

Two

Age of oldest parent as of 12/31/2023(Required)

Parent(s) filed taxes in 2021?(Required)

Yes

No

Parents’ total adjusted gross income(Required)See 2021 IRS Form 1040 – line 11.

Parents’ total income tax paid(Required)See 2021 IRS Form 1040 – line 22 minus Schedule 2 – line 2. If negative enter zero.

How much did Parent 1 earn from working in 2021?(Required)

For tax filers, enter the Parent 1 portion of the combined amounts from IRS Form 1040 line 1 + Schedule 1 lines 3 + 6 + Box 14 [Code A] of IRS Schedule K-1 (IRS Form 1065).

If your parent didn’t file taxes, enter the total amount of earnings from work in 2021. Add up the earnings from the W-2 forms and any other earning statements.

How much did Parent 2 earn from working in 2021?(Required)

For tax filers, enter the Parent 2 portion of the combined amounts from IRS Form 1040 line 1 + Schedule 1 lines 3 + 6 + Box 14 [Code A] of IRS Schedule K-1 (IRS Form 1065).

If your parent didn’t file taxes, enter the total amount of earnings from work in 2021. Add up the earnings from the W-2 forms and any other earning statements.

Parents’ Untaxed Income

Enter the total amount of any other untaxed income or benefits, such as workers compensation; Black Lung Benefits; untaxed portions of Railroad Retirement Benefits; and foreign income not taxed by any government, disability benefits, etc., that your parents received in 2020.

Also include the untaxed portions of health savings accounts from IRS Form 1040 Schedule 1-line 25.

Parents’ total savings(Required)Total value of cash, savings, and checking accounts

Parents’ net investment assets(Required)

Net investment assets include the current value minus debts related to real estate (other than the home in which you live), stocks, bonds, certificates of deposit, and 529 plans owned by parents.

Assets do not include the home in which you live, the value of life insurance, retirement plans (401[k] plans, pension funds, annuities, non-education IRAs, Keogh plans, etc.), or the value of small business or family farm.

Student Information

Student's age as of 12/31/2023(Required)

Student filed taxes in 2021?(Required)

Yes

No

Adjusted gross income(Required)See student’s 2021 IRS Form 1040 – line 11. Include spouse’s AGI if married but filed separately.

Income tax paid(Required)See student’s 2021 IRS Form 1040 – line 22 minus Schedule 2 – line 2. If negative enter zero. Include spouse’s income tax paid if married but filed separately.

Student’s total income from work in 2021(Required)

For tax filers, enter the combined amounts from IRS Form 1040 line 1 + Schedule 1 lines 3 + 6* + Box 14 [Code A] of IRS Schedule K-1 (IRS Form 1065).

If your didn’t file taxes, enter the total amount of earnings from work in 2021. Add up the earnings from the W-2 forms and any other earning statements.

Spouse’s total income from work in 2021

For tax filers, enter the combined amounts from IRS Form 1040 line 1 + Schedule 1 lines 3 + 6* + Box 14 [Code A] of IRS Schedule K-1 (IRS Form 1065).

If spouse didn’t file taxes, enter the total amount of earnings from work in 2021. Add up the earnings from the W-2 forms and any other earning statements.

Student’s Untaxed Income

Enter the total amount of any other untaxed income or benefits, such as workers compensation; Black Lung Benefits; untaxed portions of Railroad Retirement Benefits; and foreign income not taxed by any government, disability benefits, etc., that you (and, if married, your spouse) received in 2020.

Also include the untaxed portions of health savings accounts from IRS Form 1040 Schedule 1-line 25.

Student’s savings(Required)Total value of cash, savings, and checking accounts. Include savings of spouse if married.

Student’s net investment assets(Required)

Include net investment assets of spouse if married.

Net investment assets include the current value minus debts related to real estate (other than the home in which you live), stocks, bonds, certificates of deposit, and 529 plans owned by the student (this is rare).

Assets do not include the home in which you live, the value of life insurance, retirement plans (401[k] plans, pension funds, annuities, non-education IRAs, Keogh plans, etc.), or the value of small business or family farm.

Is the student’s spouse enrolled in college at least half time?(Required)If unmarried check “No”

Yes

No

3134 E Medicine Lake Blvd.
Plymouth, MN 55441-3008

Fax: 763.412.2047

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