Emergency Grant Request Form Emergency Grant Request Form If you are experiencing an emergency situation that is a barrier to your education, complete this request to be considered for emergency funding. Limited funds are available. Grants are reviewed on the next available Tuesday and are limited to one per semester. Grant Eligibility(Required) I have already received a grant from the Palomar College Foundation this semester I have not received a grant from the Palomar College Foundation this semester My greatest need is (select one):(Required) Emergency Funds ($50-$250) Textbook Assistance Computer Specs ⋄⋄⋄ Lenovo Thinkpad with: Windows 10 Pro, Microsoft Office Home & Student 2019, 12″ screen, 8 GB drive, 64 bit operating system x64 processor, touch screen Name(Required) First Last Student ID(Required) Email(Required) Cell Phone Number(Required)Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Number of Units Currently Enrolled (Will be Verified)(Required)Have you completed a FAFSA for the current year?(Required) Yes No Employment Status(Required) Full-time (32 hours a week or more) Part-time (Less than 32 hours a week) Not currently employed Military Affiliation(Required) I am a Military Veteran I am Active Duty or Active Duty Military Affiliate N/A Required Questions Please answer the following questions to be considered for Emergency Grant Funding. *150 word minimum for consideration! Please provide a brief explanation of the emergency you are experiencing that warrants an emergency grant to continue your education.(Required)Please describe your efforts to obtain assistance for these unexpected expenses through other sources (family, friends, campus/community organizations, etc.)(Required)If this is not your first time requesting emergency funding from the Palomar College Foundation, please indicate when and what other funds you have requested and received:I certify that all information given on this application and other documents is true and complete to the best of my knowledge. I authorize Palomar College Foundation to release academic and financial information to scholarship donor(s). The Palomar College Foundation may also use the information I have provided for publicity purposes.(Required) I authorize Δ
