Emergency Assistance Application

Emergency Assistance Application

The Mid Michigan College Foundation's Student Emergency Fund provides one-time grants to help students cover the costs of unexpected emergency needs that would otherwise prevent students from being able to complete their coursework at Mid. This funding is made available through donations from community members, local businesses, Mid staff, faculty, and alumni.

Application Instructions
1. Complete the student information section of this application.
2. Submit completed application.
3. You will be contacted within 5 business days via your MidMich email or the phone number you provide regarding a decision or request for additional information. A need for additional information may delay a decision to award funding, so it is in your best interest to provide as much documentation and information as possible in your initial application.
4. If approved, you are strongly encouraged to sign up for direct deposit so you can receive the funds quickly. If you are in need of a printed check, the process to distribute funds could take up to an additional 7 days from request approval.

Student Information
Name*

First NameLast Name
Mid Student ID Number*
This can be found on your Student ID card or in your account via Self-Service.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
MidMich Email*
example@midmich.edu
Are you enrolled in the current, active semester at Mid?*
If yes, are you enrolled part-time or full-time?
Per semester, full-time is defined as 12 or more credits, and part-time is less than 12 credits.
Amount Requested*
The amount requested may not be more than $250.
Amount Requested
The amount requested may not be more or less than $250.
How do you plan to use the requested funds? Select all that apply.*

BooksBroadbandChildcareFoodHousing/RentMedicalTransportationUtilities
Upload Supporting Documents.*

Browse Files
Supporting documents may include invoices, quotes, eviction notice, utility shut-off notice, car repair quote, etc. Cancelof
Briefly explain your need for emergency assistance and how it would help you achieve educational success.*
Signature*

Clear
Today's Date*

MonthDayYear
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Internal Use Only
Financial Aid Review

MonthDayYear
Financial Aid Review Notes
Academic Progress Review

MonthDayYear
Academic Progress Review Notes
Application Status

ApprovedDenied
Total Amount Awarded
Date Amount Awarded

MonthDayYear
Method of Distribution
Should be Empty:

Emergency Assistance Application

Application Instructions

Student Information