OFFICE OF FINANCIAL AID
4525 Education Park Drive, Schnecksville, PA 18078
P 610.799.1133 | F 610.799.1798
E finaid@mymail.lccc.edu
2019-20 Budget Increase Request
Student Name Student ID
Instructions
You have requested a review of your financial aid budget. The information below will be considered to
determine if your financial aid budget should be increased due to extraordinary expenses. Complete steps 1
through 4 below.
1. My Address: ______________________________ __________________________________
Street City, State, ZIP
2. My MONTHLY Expenses (not covered by government assistance/subsidies) Please include documentation
of all expenses listed below:
Rent/Mortgage
$
Child Care
$
Utilities
$
Insurance
$
Car/Transportation
$
Food
$
Dental
$
Medical
$
Children’s Tuition
$
*Other
$
*Expenses listed as “othermust be explained in detail. Please attach additional sheets or documentation
as necessary.
3. Sign below. I certify that the above information is true and correct to the best of my knowledge:
U____U
Student Signature Date Daytime Phone Number
4. Return this form in person, by mail, fax, or email to the Financial Aid Office.
OFFICE USE: BUDADJ