2019 APPLICATION

Application Instructions

Before applying, be sure to review the Minnesota Afterschool Advance eligibility requirements and expectations.

This application includes the following sections:
  • Student information
  • Student eligibility check
  • Parent/Guardian information
  • Parent/Guardian eligibility check
  • Program rules acknowledgement
If you have questions, contact us by email or phone at (763)-202-9012.

Student Information | (Page 1 of 7)





mm/dd/yyyy







For data reporting purposes only

Select all that apply. For data reporting purposes only
Student Contact Information
If you would like to grant us permission to communicate directly with the student about Minnesota Afterschool Advance, please provide any of the following contact information.



Student Eligibility Check | (Page 2 of 7)



A student is only eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit if they currently attend public or private school or are homeschooled.  


Based on your answer, we recommend not continuing with the application as your student is unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.




To be eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit, no other person may claim the student as a dependent on their 2019 income tax return.  


Based on your answer, we recommend not continuing with the application as your student is unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.


A student is only eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit if they will have a social security number that is valid for employment purposes before April 15, 2020.  


Based on your answer, we recommend not continuing with the application as your student is unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.

Parent or Guardian 1 Information (Page 3 of 7)

This should be the parent or guardian who will claim the student as a dependent on their 2019 tax return.





mm/dd/yyyy
Address











Please provide at least one phone number.





A student is only eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit if they live with this parent/guardian for more than half the year in 2019.  


Based on your answer, we recommend not continuing with the application as your student is unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.

Parent or Guardian 2 Information (Page 4 of 7)

You must complete this page if you plan to file a joint tax return in 2019.  Otherwise, you may skip it.





mm/dd/yyyy
Address











Please provide at least one phone number.





A student is only eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit if they live with this parent/guardian for more than half the year in 2019.


Based on your answer, we recommend not continuing with the application as your student is unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.

Parent/Guardian Eligibility Check (Page 5 of 7)


In order to be eligible to participate in the Minnesota Afterschool Advance program to receive financial assistance toward the cost of eligible afterschool activities, we need to gather information to determine whether your family may be eligible for the Minnesota K-12 Education Tax Credit.
Tax Filing


You are only eligible for Minnesota Afterschool Advance and the Minnesota K-12 Education Tax Credit if you will be filing a Minnesota income tax return for 2019.


Based on your answer, we recommend not continuing with the application as you are unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.



If you are married and filing separate returns, by law  you are not eligible for the Minnesota K-12 Education Tax Credit and Minnesota Afterschool Advance.


Based on your answer, we recommend not continuing with the application as you are unfortunately not eligible.  If you have questions, please contact Matt Norris, Director of Minnesota Afterschool Advance, at matt.norris@vennfoundation.org or (763)-202-9012.


For informational purposes only. You answer does not affect your eligibility.

For informational purposes only. You answer does not affect your eligibility.

For informational purposes only. You answer does not affect your eligibility.
Qualifying Children

1.     Eligibility and income limits are based in part on the number of “qualifying children” that you can claim as dependents during the current tax year.  In order to be a “qualifying child,” all of the following must be true:

  • The child is (1) your biological child, adopted child, stepchild, foster child, or descendent of any of them like your grandchild, or (2) your sibling, half-sibling, step-sibling, or a descendent of any of them like a niece or nephew.

  • At the end of 2019, the child will be younger than you (and your spouse, if filing jointly) and younger than 24.

  • The child must live with you (or your spouse, if filing jointly) for more than half of the year.

  • No other person will claim the child as a dependent on their individual income tax return for 2019.

  • The child has a social security number that is valid for employment purposes (or will have it before April 15, 2020).

  • The child will be in grades K-12 during Fall 2019 and attends public or private school or is homeschooled.


Household Income
To qualify for the tax credit and Minnesota Afterschool Advance, your household income in 2018 AND 2019 must be $33,500 or less. 

Please provide your actual income amounts for 2018 (your tax return will be helpful for completing some of the amounts) and the most accurate possible estimate of your 2019 household income for the full year. (If your actual 2019 household income ends up being above $33,500, you will be required to repay the loan from Minnesota Afterschool Advance out of your tax refund this year or in future years.)  

Enter the following types of taxable and nontaxable income in 2018 and 2019. Enter amounts as whole numbers without dollar signs, commas, or decimal points (e.g. "10000").  Use "0" if you have none of that particular income type.
2019 Estimated Income 2018 Actual Income
Federal adjusted gross income
From line 7 of Form 1040
Deductions for payments made to an IRA, SEP, or SIMPLE plan
Line 4a minus Line 4b on Form 1040
Nontaxable social security benefits received and not included in your Federal adjusted gross income above
Line 5a minus Line 5b on Form 1040
2019 Estimated Income 2018 Actual Income
MFIP (Minnesota Family Investment Program)
MSA (Minnesota Supplemental Aid)
SSI (Supplemental Security Income)
GA (General Assistance)
GRH (Group Residential Housing)
2019 Estimated Income 2018 Actual Income
Other programs including refugee cash assistance and emergency assistance
Additional nontaxable income including contributions to a 401(k) or deferred compensation plan, worker's compensation, interest and mutual fund dividends, pension and annuity payments, and grants and scholarships.
2019 Estimated Income 2018 Actual Income
Total Income
Do not include the following in your estimate: 

  • Minnesota property tax refunds
  • Child support payments
  • A dependent’s income, including Social Security
  • Any state income tax refunds not included in your Federal adjusted gross income
  • The dollar value of food, clothing, food stamps, and medical supplies received from government agencies
  • Payments from life insurance policies
  • Fuel assistance payments
  • Gifts and inheritances

Required Forms (Page 6 of 7)

There are several paper forms (detailed below) that you will need to submit before we can process your application.  Please select how you prefer to complete these paper forms.  It is important that you complete whichever option you select within a week, so we can get your application processed in a timely manner.

Here's some more information about the forms you will have to submit.

Form M1EDA

1.     This form will be filed with the Minnesota Department of Revenue to assign your Minnesota K-12 Education Tax Credit to the Venn Foundation in repayment of the loan you receive as part of Minnesota Afterschool Advance.

Form M1EDR

This release will allow Minnesota Afterschool Advance to access information on file with the Minnesota Department of Revenue about any tax debts, child support debts, or other claims against your tax returns that might be paid out of your refund before the loan provided by Minnesota Afterschool Advance.  This information will not impact your eligibility for Minnesota Afterschool Advance in 2019.

Minnesota Afterschool Advance Loan Agreement

This loan agreement will not become effective until you are accepted to Minnesota Afterschool Advance, you select one or more activities to participate in, and you pay the required family contribution.

Program Participation Agreement (Page 7 of 7)

In order to participate in Minnesota Afterschool Advance, I understand and agree to the following program requirements:
1. Minnesota Afterschool Advance (through the Minnesota K-12 Education Tax Credit) will cover 75% of the qualifying expenses for approved programs, up to $1,000 or the maximum credit allowed based on my family’s income.  My family is responsible for the remaining 25% of the cost of the programs and any non-qualifying expenses. 


2. 
I will sign a document (Form M1EDA) that will be filed with the Minnesota Department of Revenue to assign my tax credit for K-12 expenses to Venn Foundation in repayment of the loan I receive as part of Minnesota Afterschool Advance.  This means:

  • Any income tax refunds my family would have received will be issued to the Venn Foundation until this loan is repaid.
  • If a refund my family is owed is more than the unpaid loan balance, I will receive the remaining refund after the loan is paid.
  • If I separate from or divorce my spouse while this assignment is in place, both of us will continue to be responsible for the loan.
  • This assignment cannot be revoked by my family.  Once it is signed, it will stay in place until the loan is paid in full or Venn Foundation cancels it.
  • The Minnesota Department of Revenue will send me a notice each time a refund is issued to Venn Foundation and include the amount of the refund.
  • Venn Foundation will not seek repayment of the loan outside this tax credit assignment process (e.g., Venn Foundation will not call you seeking repayment, send you threatening letters, etc.).


3. My family will be limited to using Minnesota Afterschool Advance funds only for out-of-school-time providers that are approved for this program.



4. I will sign a release (Form M1EDR) to allow Venn Foundation access to information on file with the Minnesota Department of Revenue about any tax debts, child support debts, or other claims against my tax returns that might be paid before the loan provided by this program.



5. If my child is accepted to Minnesota Afterschool Advance, I select one or more activities for my child to participate in, and I pay the required family contribution, I will be entering into a loan agreement with Venn Foundation.



6. Any information I share with any of the Minnesota Afterschool Advance collaborating organizations (including, but not limited to, Venn Foundation and Youthprise) may be shared with the other collaborating organizations and their agents as necessary to administer the program.



7. All funds available as a result of your participation in Minnesota Afterschool Advance will be maintained in a pooled bank account at Sunrise Bank along with money belonging to other program participants.  Youthprise will be the owner of record on this account.  Even though the money will not be held in a separate account, Youthprise will manage and will track money belonging to my family separately from money belonging to other program participants.  At the end of the program period, Youthprise will provide my family with a full accounting of all deposits and debits made by my family or on our behalf.  I understand I will not have access to this account or any of the funds in it, and Youthprise will pay for the out-of-school-time activities I participate in through Minnesota Afterschool Advance directly to the service provider using my funds in the account.



8. I understand the submission of this application is only to determine eligibility for the Minnesota Afterschool Advance program and does not guarantee I will qualify for a loan or, even if I do qualify, that I will be provided a loan under this program.


By typing my name below, I indicate that I understand and agree with the statements above and that the information provided in this application is true and accurate to the best of my knowledge. (Both parent(s)/guardian(s) must sign if you will be filing taxes jointly this year.)



Both parent(s)/guardian(s) must sign if you will be filing taxes jointly this year