FCTC Grant Application

CFF FINANCIAL AID AWARD APPLICATION
INTRODUCTION
The California Fire Foundation (CFF) believes every person should have an equal opportunity to pursue employment within the fire
service regardless of financial circumstances. CFF has partnered with the Firefighter Candidate Testing Center (FCTC) to offer a
Financial Aid Award to cover all event fees associated with the Candidate Physical Ability Test (CPAT) and the FCTC Written Test.
Must be a California resident to apply.

Before beginning this application, please make sure to have the following:
- FCTC Account (with FCTC ID number avaliable)
- Documentation to verify eligibility:
  - Recipient of Government Financial Assistance: Unemployment insurance (UI) Benefits, CalWORKS, CalFRESH, Medi-Cal or Supplemental Security Income (SSI/SSP)
  - Income based Eligibility: Proof of income
The CFF Financial Aid covers all pre-employment event fees associated with the Firefighter Candidate Testing Center (FCTC).
These fees include:

Candidate Physical Ability Test (CPAT)
- Two (2) CPAT Orientations (included with the test)
- Two (2) CPAT Practices
- One (1) CPAT Test
FCTC Written Test
- Two (2) FCTC Written Test Preparation Courses (either in-person or online)
- One (1) FCTC Written Test
For more details please reference: FCTC website.
Legal Full Name*

First NameLast Name
Preferred First Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
FCTC ID #*
Please login to your FCTC account to access. This will be listed next to your name.
Driver's License #*
QUALIFICATION OPTIONS TO APPLY FOR A CFF FINANCIAL AID AWARD

QUALIFICATION OPTIONS TO APPLY FOR A CFF FINANCIAL AID AWARD
Please select which option you fall under:*

Option 1: Receive Government Financial AssistanceOption 2: Income Based Eligibility (based on Last Year's California Federl Tax Return)Option 3: Line of Duty Death or Permanent Injury
Option 1: California resident and receive financial assistance*

Unemployment Insurance (UI) BenefitsCalWORKS, CalFRESH, or Medi-CalSupplemental Security Income (SSI/SSP)
Unemployment Insurance (UI) Benefits: REQUIRED DOCUMENTS full-page (computer size) screen shot of UI Profile Page, showing your name and current address along with a full-page (computer size) screen shot of your Payment Schedule Page, showing your last UI payment within the last 30 days.
CalWORKS, CalFRESH, or Medi-Cal:REQUIRED DOCUMENT: Color copy of your program card.
Supplemental Security Income (SSI/SSP): REQUIRED DOCUMENTS: Award letter and last pay statement within the last 30 days.
Option 1: REQUIRED DOCUMENT(S)*

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Option 2: Income Based Eligibility (based on Last Year's California Federl Tax Return)*

Applicant is claimed as a DEPENDENTApplicant is filing as SINGLE OR HEAD OF HOUSEHOLDApplicant is filing as a MARRIED/DOMESTIC PARTNER
REQUIRED DOCUMENT(S): Applicant must submit a copy of parent(s) or legal guardian(s) Tax Return(s). Their verified income may not exceed the Tax Return Maximum Income Levels.
REQUIRED DOCUMENT(S): Applicant must submit a copy of their Tax Return. Your verified income may not exceed the Tax Return Maximum Income Levels.
REQUIRED DOCUMENT(S): You must submit a copy of both you and your spouse/domestic partner’s Tax Return. Your joint verified income may not exceed the Tax Return Maximum Income Levels.
Option 2: REQUIRED DOCUMENT(S)*

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Line of Duty Death or Permanent Injury*

An applicant who is the child of a firefighter killed or permanently disabled due to injuries sustained in the line of duty is eligible to apply for the CFF Financial Aid Award until their 26th birthday. If you qualify for this option, please complete application and contact the California Fire Foundation at 800-890-3213 and ask for the Financial Aid Department.
DEMOGRAPHIC QUESTIONNAIRE

The California Fire Foundation does not discriminate on the basis of race, color, religion, national origin, sex, disability status, protected veteran status, age, or any other characteristic protected by law. Your responses to the following questions will not be used to determine acceptance.
Gender*

WomanManNon-BinarySelf Identify
Race and/or Ethnicity*

American Indian, Alaskan Native, and/or IndigenousBlack or African AmericanEast AsianHispanic and/or Latina/o/xNative Hawaiian and/or Pacific IslanderSouth AsianSoutheast AsianWhite non-HispanicSelf IdentifyNot ListedPrefer to not respond
Race and/or Ethnicity - Self Identification
Race and/or Ethnicity - Not Listed
ACKNOWLEGEMENT OF TERMS AND CONDITIONS
All information contained in the CFF Financial Aid Application is CONFIDENTIAL and is only used for the purpose of determining eligibility for the CFF Financial Aid Award. Financial and personal information as well as award status is not accessible and is not shared with anyone. This includes Fire Service and HR personnel, as well as hiring agencies.
I have read and completed the application. I have attached the required documentation and understand that any false statement or failure to provide required documentation will be cause for denial of my application.
Please select if you are a dependent applicant (under the age of 18) and require a parent/legal guardian signature.I am 18 years old or older.
Please verify that you are human*
Applicant Signature*

Clear
Full Name of Parent/Legal Guardian*

First NameLast Name
Parent/Legal Guardian Signature*

Clear
PARENT(S)/LEGAL GUARDIAN(S) SIGNATURE (DEPENDENT applicants only)
Yearly Email
example@example.com
Should be Empty:

Family Household Size (Include Yourself)	Maximum Adjusted Gross Income (Income After Deductions)
1	$23,184
2	$31,356
3	$39,528
For Each Additional Family Member Add	$8,172

CFF FINANCIAL AID AWARD APPLICATION

QUALIFICATION OPTIONS TO APPLY FOR A CFF FINANCIAL AID AWARD

DEMOGRAPHIC QUESTIONNAIRE

ACKNOWLEGEMENT OF TERMS AND CONDITIONS