Postdoctoral Family Assistance Grant

1. Applicant Info (required)

First Name:

Last Name:

Email:

2. Enrollment Info (required)

School:

Academic Department:

Status:

Appointment Start Date:

Appointment End Date:

Which program are you applying for?

3. Childcare Assistance (required)

Please provide the range of dates you are requesting childcare assisatance (No earlier than 09/01/2023 or later than 08/31/2024. Documentation will be required.)

Assistance Start Date:

Assistance End Date:

Monthly Childcare Costs:

Will you receive childcare financial assistance from another source?

Yes No

5. Monthly Living Expenses (required)

Rent/Mortgage

Medical Insurance

Out of pocket medical costs (co-pays, medications, etc.)

Total

6. Child Support (required)

Have you received and/or paid any child support in 2023 ? (Regular payments as part of a divorce or other agreement not reflected on your tax return)

Yes No

7. Living Arrangements (required)

Do you own or rent your property?

Own Rent

8. Household Income (required)

Are you currently funded with salary or stipend?

How is your household income divided? Provide estimates for the annual academic year periods from September 1 through August 31.

Annual Salary/Stipend 2023-2024

You:

Co-parent:

Total:

Anticipated Salary/Stipend 2024-2025

You:

Co-parent:

Total:

What is your 2023 Adjusted Gross Income for you and co-parent (if applicable)? (Please note if you have completed a US federal tax return, you can locate the AGI on your 1040, Line 11)

What is your estimated combined 2024 AGI (Adjusted Gross Income) for you and co-parent (if applicable)?

If there is a significant change (greater than $10,000) between the two referenced tax years, please provide an explanation to the committee about this change:

9. Assets (required)

Do you have any retirement savings?

Yes No

If your family has more than $25,000 in cash or investments (stocks, money market funds, trusts, etc. not including retirement assets) please provide the total asset amount.

10. Special Circumstances (optional)

Please let us know of any special circumstances not reflective in your application that you want to inform the committee.

Explanation:

11. Confirm & Upload Documents (required)

Consent

By submitting this financial aid application and uploading documents, I hereby consent to Stanford University’s collection and processing of any sensitive personal data contained in my application and documents to evaluate my application for the other purposes described in Stanford University’s Online Privacy, Offline Privacy Policy, and the Privacy Notice for Admissions and Financial Aid which can be found at privacy.stanford.edu

By entering my Stanford ID number below, I am certifying that all information in this application is accurate and complete to the best of my knowledge.

Student ID:

Today's Date:

Form version:

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Financial Aid Office

Postdoctoral Family Assistance Grant — Request Form

Outside Agency Assistance Information:

Household Information:

Annual Salary/Stipend 2023-2024

Anticipated Salary/Stipend 2024-2025

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