Emergency Grant Application- Student 2025/2026 Emergency Grant Request Form Name(Required) First Last Student ID(Required)Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell Phone Number(Required)Email(Required) Choose ONE Assistance Option:(Required) Emergency Grant Textbook Assistance Chromebook Laptop Request Please provide a brief explanation of how this grant/assistance will help you reach your educational goals at Palomar College this semester(Required)Please provide a brief explanation of the emergency you are experiencing that warrants an emergency grant(Required)Have you recieved assistance from the Palomar College Foundation before?(Required) Yes No If yes, when did you receive assistance from the Foundation (ex: Fall 2024)Have you completed a FAFSA application for the 2025/2026 year?(Required) Yes No Not Yet Have you received Financial Aid for the 2025/2026 school year?(Required) Yes No Not Yet Employment Status(Required) Full-time (32 hours a week or more) Part-time (Less than 32 hours a week) Not currently employed Date of Last EmploymentNumber of Units Currently Enrolled (Will be Verified)(Required)Please describe what other campus resources you have received help from (or will receive help from) this semester (For example: EOPS, Rising Scholars, Veterans Resource Center, etc.)(Required)Total Amount of Emergency Grant Aid Requested(Required)Please enter a number from 50 to 250.**If approved, checks will be mailed to the address provided on this form**Please attach any supporting documentation for verification (receipt, bill, link to item needing to be purchased) Drop files here or Select files Max. file size: 49 MB, Max. files: 3. If you are requesting a textbook, please include ISBN# and TitlePlease note, funds are limited. Submitting an application does not guarantee that a grant will be approved. You must receive a referral from a Palomar College employee (instructor, counselor, etc.) for your application to be processed.(Required) I acknowledge this statement 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
