Fluor Foundation
Living Expense Grant Application
Please complete the application in its entirety and do not leave items blank. Additional sheets may
be attached as needed.
Name ATC ID# Marital Status
Address City State Zip
Cell Phone Home Phone Email Address
Academic Information
Program of Study Expected Date of Completion
Military Background
Are you a? Veteran Active-Duty Service Member Reservist
Are you receiving VA Education Benefits or Federal Tuition Assistance (TA)? Yes No
If yes, which benefit type? Post 9/11 Chapter 30 Chapter 1606 Reservist
TA Voc Rehab
Financial Aid
Are you receiving Federal Aid - Pell Grant/Student Loan(s)? Yes No
If so, list all sources of aid you currently receive.
Living Expenses
1) Are you employed? If yes, Full-time Part-time
2) Do you currently own (or are purchasing), or rent your home? Own Rent
3) Are you or your spouse (if applicable) currently receiving any government-funded aid to help
with living expenses? If so, list aid you are receiving.
(Complete other side)
4) How many dependents did you and your spouse (if applicable) claim on your most recent
income tax return?
5) What, if any, transportation barriers do you have?
Statement of Need
Describe why you need assistance with living expenses while attending ATC? (Attached additional
page(s) if needed or attach typed document).
By signing below, I acknowledge and understand that all information I have provided is true to the best of my
knowledge.
Signature Date