http://www.TheChicagoSchool.edu Apply to start your Psychology Degree by enrolling with The Chicago School of Professional Psychology. The Chicago School is a not-for-profit, accredited institution with more than 3,500 students at campuses across the country (Chicago, Los Angeles and Orange Counties, Calif., and Washington, D.C.) and online. As the nation's oldest and largest graduate school devoted exclusively to psychology and related behavioral science, TCSPP offers more than 20 degree programs and a wealth of opportunities for international experiences.

1.
Financial Aid Office
325 N Wells, Chicago, IL 60654
Phone: 800.684.2890 ‐ option 1
Scholarship for Disadvantaged Students (SDS) 2011 – 2012
Overview
The Scholarship for Disadvantaged Students program is funded through the Department of Health and Human
Services Administration (HRSA). To be considered for the SDS scholarship students must be enrolled in one of the
qualifying programs (listed below) and able to demonstrate they came from either economically disadvantaged
or environmentally disadvantaged background. Award amounts vary and will be determined based on the
number of qualifying applicants, as well as the amount of grant money received from the HRSA.
Eligibility Criteria
Enrollment Status: Awardees must be enrolled as a full time degree seeking student in the following programs to
be eligible for consideration and awarding of the 2011‐2012 scholarship:
 Psy.D. Clinical Psychology (Chicago, Los Angeles and Washington D.C campuses only)
 M.A. Marital and Family Therapy (Los Angeles, Irvine and Westwood campuses only)
 M.A. Clinical Psychology, Counseling Specialization (Chicago and Grayslake campuses only)
Financial Aid Status: All applicants must submit a FAFSA as part of the consideration process and the student’s
current Expected Family Contribution (EFC) will be considered in the awarding process.
Citizenship Status: Students must be citizens, nationals, or lawful permanent residents of the United States, the
District of Columbia, the Commonwealths of Puerto Rico or the Marianas Islands, the Virgin Islands, Guam,
American Samoa, the Trust of Territory of the Pacific Islands, the Republic of Palau, the Republic of the Marshall
Islands, or the Federated State of Micronesia. Applicants who are permanent residents must provide a copy of
permanent resident card.
Disadvantaged Background: The SDS Scholarship program seeks to support students who have come from an
economically or environmentally disadvantaged background as defined below:
Environmentally disadvantaged is defined as an individual who comes from an environment that has
inhibited the individual from obtaining the knowledge, skills, and abilities required to enroll in and graduate
from a health professions school, or from a program providing education or training in an allied health
profession.
The Chicago School will consider applicants who meet one or more of the follow criteria to be from an
environmentally disadvantaged community.
1. First generation college student
2. Graduated from a high school with low ACT/SAT score based on most recent data available
3. Graduated from a high school from which, based on most recent data available:
a. low percentage of seniors receive a high school diploma; or
b. low percentage of graduates go to college during the first year after graduation.
4. Graduated from a high school with low per capita funding

2.
5. Graduated from a high school at which, based on most recent data available, many of the enrolled
students are eligible for free or reduced price lunches.
6. The individual comes from a family that receives public assistance (e.g., Aid to Families with
Dependent Children, food stamps, Medicaid, public housing):
7. The individual comes from a hometown county that is designated under section 332 of the Act as
a health professional shortage area by HRSA (see instructions below)
Economically Disadvantaged is defined as an individual that comes from a family with an annual income
below a level based on low‐income thresholds according to family size published by the U.S. Bureau of the
Census, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary of Health
and Human Services for use in health professions and nursing programs. This data can also be found on the
Federal Register website from March 16, 2011.
Limits for the 2011‐2012 award year are as follows:
Family Size* Maximum Income Level**
1 $21,780
2 $29,420
3 $37,060
4 $44,700
5 $52,340
6 $59,980
7 $67,620
8 $75,260
*Number of exemptions listed federal income tax forms (Applicants 24 and under
must supply parental tax forms)
**Adjusted gross income for calendar year 2010 (income chart is subject to change)
For each additional family member add $7,640
To determine if a student meets this definition, the students’ parent(s) tax information will be used if
necessary. If a student was at least 24 years old as of June 1, 2011 and has not been listed as a dependent on
his or her parent(s)’ taxes for the previous years, parental taxes may not be required.
Selection of Recipients: Applications for incoming students are due by August 20, 2011. Incomplete applications
will not be considered. Preferences will be given to applicants who meet any of the following criteria:
 Recipient and participant in an academic enrichment program funded by the Health Careers Opportunity
Program (HCOP) or the Department of Education (DOE) – (e.g. Ronald McNair Scholar Program, TRIO, etc.)
 Where the cost of attendance would constitute a severe financial hardship for the student
 Awards will be made to applicants in the order of greatest need
Financial Need:
 You MUST provide all required Tax information for you (and your spouse)
 You MUST provide all required parental Tax information (both parents required). If parents refuse, an
affidavit documenting refusal will not be admissible in lieu of tax returns.
 You MUST file a FAFSA and your Expected Family Contribution (EFC) is considered.

3.
Financial Aid Office
325 N Wells, Chicago, IL 60654
Phone: 800.684.2890 ‐ option 1
APPLICATION:
Scholarship for Disadvantaged Students (SDS) 2011 – 2012
APPLICATION DEADLINE: AUGUST 20, 2011
Please complete the following application form and include all supporting documents.
SECTION I – General Information
Name: Student ID:
Campus email: Phone:
Current Address:
City/State/Zip
I am or will be registered as a full time student: No Yes
Program: Psy.D Clinical Psychology M.A. Counseling M.A. M.F.T
Campus: Entry Year:
Citizenship: U.S. Citizen Permanent Resident (please submit copy of Permanent Resident Card)
Age as of June 1, 2011: Date of Birth:
I consider myself a member of the following I consider myself a member of the following race group(s):
ethnic group: Please check all that apply:
Hispanic or Latino American Indian or Alaska Native
Not Hispanic or Latino Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

4.
Name:
SECTION II – Student Profile
Hometown Address:
City/State/Zip/County:
High School: Graduation Year:
High School Address:
City/State/Zip/County:
Please answer the following questions:
Yes No I am among the first generation in my immediate family to complete a bachelor’s
degree.
Yes No I was a Pell Grant recipient. If yes, years received: Click here to enter text.
Yes No I was a Supplemental Educational Opportunity Grant recipient
Yes No I graduated from a high school with low ACT/SAT score based on most recent data available
Yes No I come from a family that receives public assistance (e.g., Aid to Families with Dependent
Children, food stamps, Medicaid, public housing)
Yes No I come from a hometown county that is designated under section 332 of the Act as a health
professional shortage area by HRSA (see instructions below)
List any academic achievement programs you participated in or were a recipient of in High School or College
(e.g. Health Careers Opportunity Programs, McNair, Trio, etc.):

5.
Name:
SECTION III – Materials to Provide
Required: All Applicants MUST submit the following documents for consideration:
 Completed application
 Supporting documentation (see Environmentally Disadvantaged Definition)
 Signed copy of Student/Spouse Federal Tax Return 2010, 2009, and 2008
 Tax Returns for Parent(s) 2010 (if parents are deemed necessary based upon the below chart)
Situation Required Documents for Submission
☐ If you were not 24 as of June 1, 2011 AND/OR  Signed copy of your parents 2010 Federal Income
Your parent(s) claimed you as a dependent on their Taxes
taxes for ANY of the last three years (2010, 2009,  Signed copy of your 2010 Federal Income Taxes
2008)
☐ If you were 24 as of June 1, 2011  Submit a copy of one of the following: driver’s
AND license, passport or birth certificate
You were not claimed as a dependent on your  Submit three years of Federal Income Taxes to
parent(s) tax returns in the last three years (2010, verify that you have not been claimed, please
2009, 2008) submit:
o Signed copies of your/spouses Federal
Income Tax returns for the last three
years. If you did not file taxes in any of
the prior three years, you must follow the
second option
OR
o Attached signed copies of your parent(s)’
Federal Income Taxes for the last three
years. If your parent(s)’ did not file taxes
please contact Financial Aid or other
options in documenting their financial
situation.
By signing this application, I certify that all of the information reported on this application and attached
supporting document is complete and correct. I realize that the information I provide become the sole
property to The Chicago School and will not be released to me or any other individual or institution.
Falsification of information on any and all school document, including this application, may result in
disciplinary action up to and including a revocation of the scholarship and possible dismissal for the
school. I hereby affirm that the information supplied by me on this application form is true and correct
to the best of my knowledge. Please provide your typed signature below to serve as your electronic
signature and to reflect your acceptance and acknowledgement of the above terms.
Signature: Date:

6.
Scholarship for Disadvantaged Students – Determining Health Professional Shortage Areas
To assist you in determining if you graduated from a High School in a Mental Health Professional
shortage area please follow the below directions.
Step 1:
1. Visit the Federal Financial Institute Examination Council website at http://www.ffiec.gov
2. Go to the quick link: Geocoding/Mapping System
3. Select 2010 and enter the address of the high school from which you graduated and hit SEARCH
4. Circle your county and the TRACT code
5. Print page, circle TRACT code, and exit (you may print the page as a PDF for electronic submission)
Step 2:
1. Visit the Health Resources and Services Administration’s HPSA Shortage Area by County
a. http://www.hpsafind.hrsa.gov
2. Enter the State and County in which your high school is location
3. Under ‘Discipline’ select ‘Mental Health Care’ and click ‘Show me the HSPA’s’
4. Find your County and TRACT code found under the ID column
5. If your high school’s county is listed in blue, print the page and circle the county and TRACT code (see
example below)
6. If you do not see your County’s TRACT code in the ID column you are not eligible to use the HPSA
Guidelines to make an environmental disadvantage claim.