Emergency Short-Term Loan Application

Emergency Short-Term Loan Application
season*
semyear*
semester*

Sul Ross State University
Emergency Short-Term Loan Application
{season} {semyear} ({semester})

This program is a special service to the students that need emergency financial aid at Sul Ross State
University. Loans will only be approved for emergency purposes.

Alpine Campus PO Box C-2 3107 Alpine, TX 79832 Phone: (432) 837-8050 Fax: (432) 837-8411	Eagle Pass Campus Bob Rogers Drive Eagle Pass, TX 78852 Phone: (830) 758-5021 Fax: (830) 758-5019	Uvalde Campus 2623 Garner Field Road Uvalde, TX 78801 Phone: (830) 279-3008 Fax: (830) 279-3009	Del Rio Campus 205 W ildcat Drive Del Rio, TX 78840 Phone: (830) 703-4824 Fax: (830) 703-4810
SRSU Title IV Code: 003625		Web: https://sulross.edu

All areas on this application must be completed.

Name*

First Name Last Name
A#*
Campus*

AlpineRGC
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email*
example@sulross.edu
Phone Number*

Area Code Phone Number
Provide the following information on TWO adult relatives or friends, one with a different address than you, who will generally know your whereabouts. If you are relying on aid from an individual to repay this short-term loan, you must include information for that person.
Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number*

Area Code Phone Number
Relationship*
Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number*

Area Code Phone Number
Relationship*
Please check any sources of income that you will have during this academic term that will be used to repay this loan:*

Financial Aid (all paperwork must be on file in the Office of Financial Aid)Student EmploymentCo-SignerOther
Student Employment
Where*
$ per Week*
Supervisor*
Cosigner
Co-Signer’s Name*

First Name Last Name
Co-Signer’s Email*
example@example.com
Co-Signer’s Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Co-Signer’s Employer*
Co-Signer’s Employer Phone Number*

Area Code Phone Number
Other*
Purpose of Loan*

Tuition / On-Campus Rent/Room & BoardOff-Campus RentBooks (maximum $300)
Tuition Amount / On-Campus Rent/Room & Board*
Must be enrolled in payment plan to cover only the 30% due by 1st payment
Off-Campus Rent*
Books ($300 max)*
HOGG Total*
duedate*

MonthDay Year
Date

Payment Plan	TPEG/Tuition Loan - Students MUST be enrolled in the payment plan. If students are not enrolled in the payment plan, SRSU will enroll the student in the payment plan and charge a $25 enrollment fee.
Eligibility	Applicants, in most cases must be enrolled at least half-time and be in good academic and disciplinary standing. Students on Academic or Disciplinary Probation may not be eligible. Loans shall not be given to students in default on other student loans.
Amount	The maximum loan amount will not reflect the amount of financial aid awarded to the student.
Approval	In addition to the eligibility requirements, loan approval will be determined based on prior loan repayment records and the availability of loan funds. To be approved, the student’s financial aid file must be complete.
Disbursement	Disbursement will be made only after the student has enrolled and signed a promissory note with the Financial Aid Office.
Repayment	A repayment schedule will be included as part of each promissory note. Payments shown on that schedule must be made to the University Cashier before 4:00 p.m. on the date(s) scheduled. Your failure to comply with a scheduled payment may result in all outstanding payments becoming immediately due and payable. If loan is not paid by the last day of the current semester the loan will be sent to a Collection Agency.
HOGG Loan Interest (Books, Off-Campus Housing)	Students will be charged interest at the rate of 12% per annum against the outstanding principle balance of the loan.
TPEG Loan Interest (Tuition, On-Campus Housing)	Students will be charged interest at the rate of 5% per annum against the outstanding principle balance of the loan.
Other Fees	When a loan is placed with a Collection Agency, collection costs and fees will be added to any outstanding principle and interest.

I certify that all information contained in this application is true, complete, and correct to the best of my knowledge and belief. I hereby authorize Sul Ross State University to verify any or all information provided in this application. I have read, understand and agree to all policies and procedures as stated on the back of this application.

You (and your guarantor) must sign below certifying the accuracy of the information provided on this form and certifying that this loan will be repaid, if it is approved. Any loan funds approved with be disbursed to the student account, and refunded or applied as appropriate.

If the loan is not paid by the last day of the current semester the loan will be sent to a Collection Agency.

Student's Signature*

Clear
Date Student Signed*

MonthDay Year
Date
State law requires that you be informed of the following: (1) you are entitled to request to be informed about the information about yourself collected by use of this form (with a few exceptions as provided by law); (2) you are entitled to receive and review that information; and (3) you are entitled to have the information corrected at no charge to you.

Sul Ross State University
Financial Assistance
Alpine, Texas 79832

PROMISSORY NOTE - TPEG EMERGENCY LOAN

I, {name} hereinafter called the Maker, promise to pay to Sul Ross State University, hereinafter called the Lender, located at Alpine, Texas, the sum of ${tuitionAmount37} plus interest at five percent (5%) per annum on the unpaid balance.

I. The Maker further understands and agrees, and It is understood between the parties that:

a) The Lender is authorized to apply, against this note (principal, interest, related fees and collection costs), any financial aid received on behalf of the Maker, including grants, loans, and scholarships.

b) Payments due pursuant to this note must be received by the Lender prior to 4:00 p.m. on the due dates(s) stated in this note.

c) In the event of the failure of the Maker to meet a scheduled repayment of any of the installments due pursuant to this note or if the approved source(s) of repayment cease(s) to exist, the entire unpaid indebtedness including interest due shall, at the option of the Lender, become immediately due and payable.

d) In the event of the failure of the Maker to complete any academic term for which sums pursuant to this note are advanced, the entire unpaid indebtedness including interest due shall, at the option of the Lender, become immediately due and payable.

e) In the event this note is placed in the hands of an attorney or agency for collection, or suit is brought on the Maker, or if collected through the Probate or Bankruptcy Court, all costs of such action shall be added to the note as collection costs.

f) The Maker waives demand of payment, protest, and notice of non-payment, and agrees that the dates of repayment may, at the option of the Lender, be extended and such action shall be as binding upon the Maker as if said extension had been made at the Maker's own request.

g) The Maker may, at his/her option, and without penalty, prepay all or any part of the principal plus interest due on this note.

h) The Maker shall be responsible for immediately informing the Lender of any change in the Maker's ·name, address, or phone number.

i) A fifteen dollar ($15.00) late fee will be charged if the loan is not paid by the end of the current academic term.

II. The Maker further understands and agrees, and It ls understood between the parties, that repayment of the note shall be in accordance with the following repayment schedule:
Payment Date: {duedate} Payment Amount: ${tuitionAmount37} plus interest

III. The Maker acknowledges receipt of an exact copy of this statement.
Maker's Signature*

Clear
Date Maker Signed*

MonthDay Year
Date

Sul Ross State University
Financial Assistance
Alpine, Texas 79832

PROMISSORY NOTE - EX-STUDENT/HOGG MEMORIAL LOAN

I, {name} hereinafter called the Maker, promise to pay to Sul Ross State University, hereinafter called the Lender, located at Alpine, Texas, the sum of ${hoggTotal} plus interest at five percent (5%) per annum on the unpaid balance.

I. The Maker further understands and agrees, and It is understood between the parties that:

a) The Lender is authorized to apply, against this note (principal, interest, related fees and collection costs), any financial aid received on behalf of the Maker, including grants, loans, and scholarships.

b) Payments due pursuant to this note must be received by the Lender prior to 4:00 p.m. on the due dates(s) stated in this note.

c) In the event of the failure of the Maker to meet a scheduled repayment of any of the installments due pursuant to this note or if the approved source(s) of repayment cease(s) to exist, the entire unpaid indebtedness including interest due shall, at the option of the Lender, become immediately due and payable.

d) In the event of the failure of the Maker to complete any academic term for which sums pursuant to this note are advanced, the entire unpaid indebtedness including interest due shall, at the option of the Lender, become immediately due and payable.

e) In the event this note is placed in the hands of an attorney or agency for collection, or suit is brought on the Maker, or if collected through the Probate or Bankruptcy Court, all costs of such action shall be added to the note as collection costs.

f) The Maker waives demand of payment, protest, and notice of non-payment, and agrees that the dates of repayment may, at the option of the Lender, be extended and such action shall be as binding upon the Maker as if said extension had been made at the Maker's own request.

g) The Maker may, at his/her option, and without penalty, prepay all or any part of the principal plus interest due on this note.

h) The Maker shall be responsible for immediately informing the Lender of any change in the Maker's ·name, address, or phone number.

i) A fifteen dollar ($15.00) late fee will be charged if the loan is not paid by the end of the current academic term.

II. The Maker further understands and agrees, and It ls understood between the parties, that repayment of the note shall be in accordance with the following repayment schedule:
Payment Date: {duedate} Payment Amount: ${hoggTotal} plus interest

III. The Maker acknowledges receipt of an exact copy of this statement.
Maker's Signature*

Clear
Date Maker Signed*

MonthDay Year
Date

For this page:
You may use the back button to review all entries to application. Print a copy for yourself.
Students MUST be enrolled in the payment/installment plan for Tuition/On-Campus Rent/Room & Board option.
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