IMPACT VOCATIONAL OR JOB SKILLS TRAINING FINANCIAL INFORMATION
State Form 48418 (8-97) / IMP 0025
To be completed by the Office of Family and Children
Name of client:
Social Security number:
Training Provider:
Course of study:
To be completed by the Training Provider:
FEES EFFECTIVE FOR (PERIOD):
PROGRAM COSTS APPLICATION FEE REGISTRATION FEE
PER SEM / QTR / ____
PER YEAR
TOTAL PROGRAM
TUITION
BOOKS OTHER MANDATORY FEES (LIST) TOTAL COST
FINANCIAL AID GRANTS
PER SEM / QTR / ____
PER YEAR
TOTAL PROGRAM
SCHOLARSHIPS
OTHER AID
TOTAL FINANCIAL AID TOTAL BALANCE DUE
I certify this to be an accurate statement of costs.
Signature of Authorized School Official Title Date (month, day, year)