HEP CAMP Association Student Emergency Fund
Applicant Name (first, last)
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Applicant Email
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Phone Number
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Address (Location to where the award should be mailed.)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
HEP/CAMP Staff Name who will confirm Emergency
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HEP/CAMP Staff Contact Information (email and phone number)
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Select all that apply
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Current HEP Student
Current CAMP Student
Former HEP Student
Former CAMP Student
HEP or CAMP Program Name and Institution Name
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Amount of money being requested? (up to $599)
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Please explain the event or unforeseen circumstances that have led to your emergency situation. It would be helpful if you can include as much detailed information so the committee can make an informed decision.
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Please explain how funding will be used to alleviate your emergency situation.
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Submit
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