Early Estimate Form

Enrollment status projected: (hours estimated each semester)
Name of student:
Date Prepared:
Name of Parent/Guardian:
Mailing address:
	Full Time (12 hours or more) ½ time (6-8 hours) ¾ time (9-11 hours) less than ½ time
Marital status:
	Single Married; student only enrolled at least ½ time Married; student and spouse both enrolled at least ½ time

Number in household (parents, student, siblings living at home):
Number in any college in 2007: (household members enrolled next year at Ancilla or any other college)
Current age of older parent:
Current age of student:
Expected high school graduation date: (Month and Year)
Expected high school grade point average: (Current or estimated GPA)
High School: (for anticipated 2007 high school graduates)
Expected diploma type: Regular Core 40 Honors
Is the student an Indiana resident?	Yes No
Has the student taken either the ACT or SAT exam?	Yes No
If yes, what was the ACT or SAT composite score? ACT: (Reading & Math only) SAT:
Is the student eligible for the Indiana 21st Century Scholar Program?	Yes No
Have you already applied to Ancilla College?	Yes No

The following financial data is required for both parents/guardian and student Enter 0 above for any item that does not apply.
	PARENT GUARDIAN	STUDENT
Total estimated income for 2006:
Federal Tax estimated to be paid for 2006:
Are you paying child support? If yes, monthly amount is:
Are you receiving child support? If yes, monthly amount is:
Total amount of cash, savings and investments:
Estimated net home equity:
Estimated net worth of business or farm:
Other investments: