Jefferson State Student Emergency Grant Fund Application

The Student Success Center Emergency Grant Funds provide one-time financial assistance to students who are in good standing that are facing economic hardship and have immediate monetary need that if not met, could result in an inability to complete classes or a program.

The grant will be awarded based on emergency financial need and award amounts vary based on need, with a maximum of $500. Funds may be used for purposes such as:

Assistance with utility bills with a disconnect notice
Assistance with past due childcare
Assistance with past due rent or mortgage
Assistance with car repairs/ past due car note

Please Note: Emergency Grant aid will NOT be awarded:

To cover previous college debt
To pay for full or partial tuition or college fees
To pay for legal representation in a criminal proceeding

Note: A committee will review all applications.

Students must be enrolled in at least 6 credit hours to be eligible for emergency grant funds.

Students must have a cumulative GPA of 2.0 at the time emergency grant funds are disbursed or when the application is submitted.

Proper supporting documentation must be submitted before an application is reviewed.

Applicants are required to complete a Financial Literacy Course before application is reviewed.

A student is not guaranteed any award based on submitting an application.

** PLEASE NOTE: There will be at least 14 business days for the entire process.

Upon approval, the Community Foundation will provide student with a check, made payable to vendor.

Student's Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If address on supporting documentation does not match current address on application, please provide explanation.

Phone Number

Are you currently enrolled as a Jeff State student?

YesNo

Please specify how many credit hours you are enrolled in.

Student's A- Number

Jeff State/ alabama.edu E-mail Address

example@example.com

Major/ Field of Study

Are you currently receiving a Pell Grant?

YesNo

Ethnicity

Gender

MaleFemaleNon-BinaryPrefer not to disclose

Please specify your income level.

How many people, including yourself, live in your household?

Grant Amount Requested (Maximum amount is $500.) Must attach documentation below to verify amount requested.

Statement of Need: 1. Please write a paragraph (At least 5 sentences) explaining your emergency and describing how the funds will be used. 2. Please itemize each cost and provide a total of requested amount. 3. To be considered, applicant must explain/ list specific events/ circumstances which led to you needing assistance.

Upload Documentation Here

As the student, I certify that all information provided in this application is accurate. By electronically signing below, I give permission for my data from educational, State, and/or workforce agencies to be shared with the JSCC Student Success Center for the verification of outcomes, performance, and credentials related to postsecondary education/ training and employment or other services that are provided by the Student Success Center and Jefferson State Community College.

Data Exchange Permission