Non-Custodial Parent Waiver Request

Instructions

The Jack Kent Cooke Foundation requires both of the applicant's legal parents to submit Parent Information forms as part of the review process for the Young Scholars Program. Separate parent information forms will be collected if the student's legal parents are not married to one another or do not reside in the same household. The Cooke Foundation considers the legal parents to be the applicant's biological parents, adoptive parents, or legal guardians.

The Cooke Foundation may choose to waive the requirement of the second parent's 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 parent form requirement for your student. This submission does not guarantee a waiver is granted.

Applicant (Student) Information

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

First Name

Last Name

Email Address

Birthdate

Information Required for Waiver Request

Legal Parent First Name

Legal Parent Last Name

Legal Parent Email

Legal Parent Phone Number

1. Can you identify the applicant's noncustodial parent?

Yes

No

Noncustodial Parent First Name

Noncustodial Parent Last Name

What is the highest level of education of the applicant's non-custodial parent?

What is the job title of the applicant's non-custodial parent? If they are not currently employed please list last known job title.

What is the name of the employer of the applicant's non-custodial parent? If they are not currently employed please list last known employer.

Please explain.

2. Can you locate the applicant's noncustodial parent?

Yes

No

Noncustodial Parent Address

Country

Street

City

Region

Postal Code

Please explain.

3. Can you contact the applicant's noncustodial parent?

Yes

No

Noncustodial Parent Email Address

Noncustodial Parent Phone Number

Please explain.

4. When were you or the applicant last in contact with the noncustodial parent?

5. Is there a safety concern regarding contacting the noncustodial parent?

Yes

No

Please explain.

6. Does the applicant receive any financial support from the noncustodial 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 noncustodial parent's wages be garnished?

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

Yes

No

8. Please explain any additional circumstances regarding your or the applicant's relationship with the noncustodial parent, particularly any that relate to the above questions.

9. Are there any additional reasons that would prevent the noncustodial parent from completing the other parent information form?