PCE PRE-APPLICATION INCOME AND EXPENSE WORKSHEET

PCE PRE-APPLICATION INCOME AND EXPENSE WORKSHEET
To be completed to reflect information for the term for which the grant is requested
MONTHLY INCOME (deduct taxes only)
MONTHLY EXPENSES
Salary: Applicant
Spouse
$
$
Rent Payment:
$
Mortgage Payment:
$
Financial Aid: (actual per month)
Scholarships/Grants
$
Food/Groceries/Household products: $
(if applicable, include Food Stamps/SNAP)
$
Clothing:
$
Utilities:
$
Telephone: (cell & land line)
$
Medical/Dental Exp. & Insurance:
$
$
$
$
$
Educational Loans
Financial Aid: (pending per month)
Scholarships/Grants
Educational Loans
$
$
Child Support
$
Alimony/Maintenance
$
State, Provincial, U.S., or Canadian
Government Assistance:
(identify source)
$
Automobile:
Payment
Maintenance Expense
Gasoline (non educational)
Insurance
Food Stamps/SNAP:
$
Other Insurance:
(e.g.: Life, Home, Renters, etc)
Monthly Income from
Savings/Interest/Dividend:
(list by source/amount)
Other Sources of Income:
(list by source/amount)
TOTAL MONTHLY INCOME:
$
Total Monthly Credit Card Payments:$
Total Monthly Loan Payments:
$
(excluding auto/mortgage)
Childcare (not related to education): $
$
$
Other: (list by name/amount)
$
$
TOTAL MONTHLY EXPENSE:
$
ADDITIONAL INFORMATION
EDUCATIONAL EXPENSE PER TERM
Total in All Savings Accounts:
$
Amount Available for Educational Program:
$
Total in Investments:
$
Amount Available for Educational Program: $
Tuition:
Books/Educational Supplies:
Childcare:
(while attending class or studying)
Transportation (gasoline, parking,
local public transportation):
Other:
Total in 401K/Retirement Funds:
$
Amount Available for Educational Program: $
$
$
$
$
$
TOTAL Educational Expense per Term:
Total Balance of Indebtedness:
$
(e.g., balance of mortgage, total credit card debt,
all other loan debt –excluding educational loans)
Total Past Educational Loan Debt:
$
Applicant: $
Spouse:
$
Children $
P.E.O. Program for Continuing Education:
Pre-App Income & Expense Worksheet
$
Number of Months per School Term:
Total Monthly Educational Expenses:
$
*(Total of term’s educational expenses
divided by number of months per term.)
09/2012
*