Non-Custodial Parent Waiver Request

Instructions

The Jack Kent Cooke Foundation requires both of the applicant's biological parent(s)/legal guardian(s) to submit Parent Information form(s) as part of the review process for the Young Scholars Program. This requirement includes the Non-custodial Parent Information form(s) if the student's biological parents are not married to one another or do not reside in the same household.

The Cooke Foundation may choose to waive the Non-custodial Parent Information form if that parent is incarcerated or their whereabouts are unknown and no contact can be established. Click here and view the "Application Process" section of our website for more information about the waiver process.

Please complete this form to assist us in determining the non-custodial form requirement for your student. This submission does not guarantee a waiver is granted.

Student Information

Please confirm the contact information the student used for the application.

First Name

Birthdate

Email Address

Last Name

Information Required for Waiver Request

Custodial Parent/Guardian First Name

Custodial Parent/Guardian Last Name

Custodial Parent/Guardian Email

Custodial Parent/Guardian Phone Number

1. Can you identify the non-custodial parent?

Non-custodial Parent First Name

Non-custodial Parent Last Name

Non-custodial Parent Occupation/Employer

Please explain.

2. Can you locate the non-custodial parent?

Non-custodial Parent Address

Country

Street

City

Region

Postal Code

Please explain.

3. Can you contact the non-custodial parent?

Non-custodial Parent Email Address

Non-custodial Parent Phone Number

Please explain.

4. When were you or your student last in contact with the non-custodial parent?

5. Is there a safety concern regarding contacting the non-custodial parent?

Please explain.

6. Does your student receive any financial support from the non-custodial parent, including child support payments?

Yes

No

6a. Indicate the most recent tax year in which financial support/child support was paid.

6b. How much financial support was paid that year?

6c. If child support was paid, was the child support paid court-ordered?

6d. If child support was paid, did it require that the non-custodial parent's wages be garnished?

7. To your knowledge, has the non-custodial parent ever claimed the applicant as a dependent on a federal tax return?

8. Please explain any additional circumstances regarding your or your student's relationship with the non-custodial parent, particularly any that relate to the above questions.

9. Are there any additional reasons that would prevent the non-custodial parent from completing the non-custodial parent form?