Lucky Jefferson Student Aid Request Form

Lucky Jefferson Student Aid Request Form

For students located in MA, PA, DC, MD, and NY, use this form to request financial support. For questions, please email aid@luckyjefferson.com.
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Please list your PayPal email and/or Venmo account *
Please be advised that we will award aid on a case by case basis and that the amount of aid requested is not guaranteed.
Tell us about your situation. *
How much aid are you requesting? *
Did you receive financial aid for the 2019-20 School Year? If so, how much? *
What are you hoping to do with any aid received? *
How did you hear about the Lucky Jefferson Student Relief Fund? *
Should be Empty: