Student Emergency Fund Application

Student Emergency Fund Application

Financial Aid Office
If you have any questions about this form, please contact Minot State University Financial Aid Office at 701-858-3375, 1-800-777-0750, ext. 3375 or financialaid@minotstateu.edu.

Submit your supporting documentation to the Financial Aid Office with this form or send it separately by mail, email, or fax.

Minot State University
Financial Aid Office
500 University Ave W.
Minot ND, 58707

Fax: 701-858-4310

E-mail: financialaid@minotstateu.edu
Student ID #*
Student Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Best way to reach you?*

PhoneEmail
Anticipated semester of graduation:*
How did you hear about the Student Emergency Application?
Have you enrolled in Direct Deposit with Minot State to receive any funds disbursed:*

YesNo
Direct Deposit is highly encouraged and instructions are available online.
Emergency Fund Request
Amount Requested*
Have you received funds from the Student Emergency Fund before?*

YesNo
Date prior funds received*
Prior amount received*
Explanation and Documentation
Please explain in detail the reason why the emergency funds are needed, the nature of the emergency, and what the funds will be used for. Priority will be given to students whose tenure at Minot State University may be at risk because of unexpected expenses. If your explanation does not fit within the space provided, you may submit your explanation on a separate document and upload it with this form.
Attach appropriate documentation to confirm your circumstances such as receipts, documented expense estimates, or other supporting documents.

File types accepted: PDF, DOC, DOCX, JPG, PNG

Please do not use any special characters (#",:;!&'?`~...etc.) in the file names, they may become unaccessible after upload.
Documents: limit five files at 10mb each

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