Jefferson State Student Emergency Grant Fund Application

The Student Success Center Emergency Grant Funds provide financial resources to students in good standing who are facing economic hardship and 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 amount of $500. Funds may be used for purposes such as temporary loss of job or income, homelessness or sudden loss of housing, food or transportation needs, past due utility bills with a disconnect notice, loss of childcare. Emergency grant funds are non-renewable.

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 meet Satisfactory Academic standards to be considered.

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.

Student's Name

Street Address

Phone Number

Are you currently enrolled as a Jeff State student?

YesNo

Student's A- Number

Jeff State E-mail Address

example@example.com

Major/ Field of Study

Are you currently receiving a Pell Grant or other Need-Based Grant?

YesNo

Ethnicity

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: Please write a brief statement explaining your emergency and describing how the funds will be used. Please itemize each cost and provide a total of requested amount.

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.

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Data Exchange Permission