Osteopathic Medical Student Emergency Loan Application

Financial Aid

111 University Parkway, Suite 202

Yakima WA 98901

Phone: 509.249.7888

Fax: 509.249.7907
Osteopathic Medical Student Emergency Loan Application
A small emergency loan fund has been donated by the Washington Osteopathic Foundation to assist osteopathic medical students with unexpected expenses. Submitted forms are reviewed and approved based on fund availability. The emergency loan must be repaid to make the funds available for future use by PNWU students.

Expenses that qualify as financial aid cost of attendance may be used to increase the student's federal loan eligiblity.

Please note: OMS2s must have passed COMLEX-USA Level 1 prior to requesting an emergency loan against their OMS3 financial aid.
Date*

MonthDayYear
Student Name*

First NameLast Name
PNWU Student ID:
May be found on Self-Service in Account Information under My Profile.
E-mail*
Phone Number*

Area CodePhone Number
OMS Class Level*

First-yearSecond-yearThird-yearFourth-year
Requested Amount*
Eligibility Requirements:
- Student must be an osetopathic medical student.
- Approval of emergency loan funds are made on a case-by-case basis and solely at the discretion of PNWU.
- Emergency loan funds are limited to $2500 per term. Additional loan funds may be considered by Enrollment Services, depending on availability of funds and the nature of the emergency.
- Funds will be direct deposited into the student's designated bank account.
- OMS2s must have passed COMLEX-USA Level 1 prior to requesting an emergency loan against their OMS3 financial aid.
Reason for request*
Upload Documentation of Expense:*

Browse Files

Cancelof
Would you like to request a budget revision to include this cost in your financial aid eligibility?*

YesI would like to discuss this with someone in the Financial Aid OfficeNo
- I authorize PNWU to deduct the full amount of this emergency loan from federal student aid (Title IV) at the time of the next scheduled financial aid disbursement.
- I understand that if federal student aid is not awarded to me, I must repay the emergency loan debt in full before I can register for the next semester.
- If I withdraw or am dismissed from PNWU prior to full repayment of this loan, I understand the full outstanding balance will be due at that time and/or deducted from any PNWU balances I hold.
- PNWU reserves the right to pursue repayment of outstanding loans, at its sole discretion, and to recover all appropriate fees associated with the collection of said debt, including late fee(s) and collection and legal fees.
I acknowledge that by pressing the submit button, I am officially signing this document. My typed name below is my symbol and intent of authentication where I willingly signed, understand, and adopt this document.
Student Signature*

First NameLast Name
Date*

MonthDayYear
TO BE COMPLETED AFTER REQUEST IS CONSIDERED
Status

ApprovedDenied
Amount Approved
Reason for Denial
Date Check Issued

MonthDayYear
Date Student Notified

MonthDayYear
Should be Empty:

Osteopathic Medical Student Emergency Loan Application

TO BE COMPLETED AFTER REQUEST IS CONSIDERED