The Carroll and Milton Petrie Foundation Emergency Grant Application
The purpose of the Emergency Grant program is to enable matriculated students in good academic standing who are experiencing short-term financial emergencies to remain in school. Students who demonstrate need and are facing a current emergency may apply for a grant. Please note that your application must be complete in order to be given consideration. Completion of this application is not a guarantee that you will be awarded funds. Please print legibly. Last Name: ______________________________ First Name:____________________ Address:_____________________________________ Phone#:__________________ E-Mail Address:_____________________________ EMPL ID # ___________ Grant amount requested: _________________ Did you file a ...view middle of the document...
Academic Information What year are you in? Freshman___ Sophomore___ Junior___ Senior___ Graduate Student____ What is your current GPA? ____________ Major: _______________________________ Total credits as of current semester: ____________
Part 3. Supplementary
Statement of Need: Attach a brief statement (must be typed) explaining your emergency and describing how the funds will be used. Please itemize each cost and provide a total of requested amount. Supporting Documentation: Provide as much evidentiary documentation as possible in order to support your reason for requesting an emergency grant. The more documentation you are able to supply, the better your chances for being awarded a grant. Examples of acceptable documents include medical bills, bank statements, letter from your employer stating your loss of job, letter from your landlord stating rent owed or loss of housing, police report for theft, etc. All applicants will meet with a representative of the Office of the Vice President for Student Affairs.
______________________________________________ ____________________ Student Signature Date
Application and supporting documents must be submitted to the Office of the Vice President for Student Affairs - Shuster Hall Room 204
For administrative use___________________________________________________________ MC _______ Voucher________SC________ Other________ Other________Other________ Other_______Other ________Total award_________