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Confidential Family Contribution Analysis

In our years of practice, we've come to learn how overwhelming and complex the college aid process has become. By implementing appropriate strategies the amount of aid available to you can be increased dramatically. This is very often true even for parents who think they are too wealthy to benefit!

If you would like to learn more about what the information on this form can do for you, just attend one of our Free Seminars, otherwise...

Take a few minutes to fill out this form and we will contact you very soon! You have nothing to lose but a few minutes of your time...

You may also download a printed copy of this form (the same one used at our seminars) to fill out and mail or fax to us by Clicking Here.


Last Name:         
Address:           
City, State, Zip:  
Phone:             

        We need your email address
        here in order to respond by email...
Email: 



Personal Information:

                 Father/Step-Father        Mother/Step-Mother
First Name:          
Attended Workshop?                    
Date of Birth:       


Do you currently work with a
financial advisor or investment broker? 


                                             College   Do you claim
              Child's            Date         Start      child as
             First Name        of Birth       Year?     dependent?
Child #1:       
Child #2:       
Child #3:       
Child #4:       
Child #5:       

Other Dependents:

(i.e. elderly parent, disabled sibling etc.)



Primary Residence Information:

Year Purchased: 
Purchase Price: 
Current Value:  
Amount Owed:     (Mortgage + Equity Line Used)



Income Information:
(use rounded numbers or your 2009 Federal 1040 if available)

Adjusted Gross Income:           (line 37 on 2009 1040)
Father/Step-Father Gross Wage:   (earned income from W-2)
Mother/Step-Mother Gross Wage:   (earned income from W-2)
Interest/Dividend Income:        (line 8a plus 9a on 1040)
Annual Retirement Contribution: 
Total Federal Income Tax:        (line 55 on 2009 1040)
(Exclude self-employment tax)

Other Income Information:
(Please include Amount and Description)

(i.e. Child Support Received, Child Support Paid,
 Business Loss, Social Security, Disability,
 Extreme Medical/Dental Expenses etc.)



Asset Information:

Cash and Savings:              
Investments in Parent's Names: 
(i.e.: Stocks, Bonds, Non-Real Estate,
Non-Retirement Investments)

Retirement Investments:        
Net Worth of Business/Farm:    


Real Estate other than your Primary Residence

Year Purchased: 
Purchase Price: 
Current Value:  
Amount Owed:     (Mortgage + Equity Line Used)

List Other Real Estate Information Here:
 (Please include the same four items
  for each property as listed above)




Children's Information:
                                                    Pre-Paid
                                                     Tuition
                      Int.       '09      Assets     Plans-
                       +         Fed     excluding   (UPlan,
            Gross     Div.       Tax      tuition     UFund,
            Wage:    Income     Paid:      plans    529 plans)
Child #1:     
Child #2:     
Child #3:     
Child #4:     
Child #5:     



Divorce Information:

Who is custodial parent? 

Who claims the
children as dependents?  

Is the mother re-married? 
If yes, does she file jointly with her husband? 

Is the father re-married? 
If yes, does he file jointly with his wife? 


Please tell us how you heard about Central Mass CFA:

Central Mass College Funding Advisors
290 West Main Street, Suite 19
Northborough, MA 01532
Voice: 508-739-2020
Fax: 508-739-2270