EOP Income Eligibility Scale –Academic Year 2022-2023

$25,760 - Household Size is 1 $34,840 - Household Size is 2 $43,920 - Household Size is 3 $53,000 - Household Size is 4 $62,080 - Household Size is 5 $71,160 - Household Size is 6 $80,240 - Household Size is 7 $89,320 - Household Size is 8

Annual Gross Income

First name

Last name

Age

Address

City

State

Zip

Country

Phone number

Email

High school

Graduation year

G. E. D

Yes No

Intended major?

Is/are your parent(s) university graduates?

Yes No

University(ies) attended

Do you have a sibling enrolled in or graduated from an EOF/EOP?

Yes No

If yes, what university(ies) did they attend?

Name of father/ legal guardian/ stepparent

Address

City

State

Zip

Occupation

Name of mother/ legal guardian/ stepparent

Address

City

State

Zip

Occupation

Parents' status

Single Married Divorced Widowed Remarried Separated

Are you a veteran of the United States Armed Forces or do you receive benefits?

Yes No

Are you an orphan, foster child or ward of the court, or were you an orphan, foster child or ward of the court until the age of 18?

Yes No

Marital status

Single Married Widowed Separated Divorced

Do you have any legal dependents (other than a spouse)

Yes No

Are you eligible for and do you participate in the National School Lunch Program/free or reduced price?

Yes No

Do your parent(s)/guardian(s) own a home?

Yes No

DEPENDENT STUDENTS ONLY ANSWER THESE QUESTIONS

Do your parent(s)/guardian(s) own a business/other property?

Yes No

DEPENDENT STUDENTS ONLY ANSWER THESE QUESTIONS

EOP application certification

I agree with the information I have submitted above to the best of my knowledge to be true and accurate.

Consent agreement

By submitting this form, I agree to be contacted by Centenary University about degrees, programs, issues, and events by email, text, telephone, and mail.

EOP questionnaire

Educational Opportunity Program Questionnaire