Crisis Fund Application

Crisis Fund Application

If you have applied for financial aid, please attach a copy of your award notification. Applications must be fully completed or they will not be reviewed for funding. For questions regarding crisis funds, contact the Sandburg Foundation at foundation@sandburg.edu or 309.341.5349.
Name

First NameLast Name
Carl Sandburg College Student ID#
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Sandburg Student Email Address
student@student.sandburg.edu
Degree/Certificate Program
Grade Point Average
Please list any financial support or income being received (i.e. scholarships, financial aid including Pell and Map Grants, etc.)
Name of Sandburg academic advisor
Hours Presently Enrolled
Amount of Assistance Requested ($500 is the maximum amount funded)
How did you hear about this program?
Please describe your financial situation in the space provided. Attachments may be added below, i.e. unpaid bills, etc.)
Please explain how a crisis grant or loan would help further your educational experience at Carl Sandburg College. How will this opportunity help you finish your studies at the College?
Have you communicated with Sandburg staff/faculty about your needs/hardships/emergency?
What efforts have you made to obtain funding from other sources and have you been successful?
Please include/attach copies of any and all supporting documentation. (Examples include, but are not limited to: medical bills, proof of unemployment, foreclosure, eviction) Documentation is REQUIRED.

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If awarded funds, how would you like to receive your check:

By mail (check will be mailed to the address provided above)I prefer to pick up my check in the business office
Affirmation: I have read and understand all criteria and requirements regarding Carl Sandburg College Foundation's Student Crisis Funds, and I certify that all information I have supplied on this application is correct. I understand that applying does not guarantee approval, and that applying does not obligate the Sandburg Foundation to award me a financial grant. I hereby authorize the appropriate individuals to review my student records and disseminate information to the Student Crisis Fund Committee by e-mail as necessary. I understand that the information I have submitted will be handled privately and will not be shared beyond those with a distinct need to review my application (including Dean of Institutional Planning, Title IX Coordinator, Grant Writer and Researcher, Chief Advancement Officer, Coordinator of Scholarships and Donor Relations & Annual Giving, Coordinator of Alumni and Advancement Communciations and members of the Carl Sandburg College Foundation Board of Directors). I also understand that those individuals may contact me for further information. I understand that checking this box signifies agreement with the policies outlined in this application. I also understand that, while Carl Sandburg College goes to great lengths to ensure that my information is secure, electronic submission of this information is at the sole risk of the applicant if I choose to submit electronically.
I have read and understand the above affirmation statement. Typing my name serves as my electronic signature:

Clear
Please note:

Crisis Grant Applications are reviewed regularly by a committee. Checks are produced in the Sandburg Business Office and dispersed on Thursdays only. Students awarded a grant will be notified via their Sandburg student email account.
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Crisis Fund Application

Please note: