Emergency Tuition Assistance

The Emergency Tuition Assistance grant is designed to support students’ timely graduation by alleviating financial barriers during periods of crisis. The grant provides up to $2,000 and may be awarded once per student. It is intended for students who are unable to graduate in the current semester or who are unable to register for their final semester but are otherwise eligible to graduate that term. Other exceptional circumstances may be considered on a case-by-case basis.

Name*

First NameLast Name

School ID Number

Current HBCU*

Current GPA*

Email

example@example.com

Phone Number

Current Enrollment Status*

Expected Graduation Date*

(Month/Year)

Amount of tuition owed*

Amount of Emergency Assistance requested*

Students may request up to $2,000 and must show proof of need. Payments are made directly to the student's college/university.

Deadline by which payment must be made to remain enrolled or graduate*

Briefly describe the emergency or unexpected circumstance that created this financial need: *

Please address: When did this circumstnace occur? Was this situtation beyond your control? How has this emergency affected your ability to pay tuition? Examples for guidance: Loss of income or employment, medical emergency, housing or food insecurity, family crisis or caregiving responsibility, natural disaster or unforseen event.

Confirmation of outstanding tuition*

Transcript *

Photo*

Your photo should depict you in a professional light. Your face should be clearly visible (avoid ball caps, sunglasses, or heavily pixilated or dark images. Your photo should be a headshot, depicting you from the neck up; however, a family photo is also acceptable.

I agree to allow the institution to verify my enrollment and tuition balance.*

I agree

I acknowledge and understand that the JL Winston Foundation ("Foundation") and individuals associated with and authorized by the Foundation may take photographs, video and/or audio recordings during activities and interviews in connection with my application to the Foundation. I hereby irrevocably grant the Foundation the worldwide and perpetual right, but not the obligation, to take, edit, copy, publish, distribute or use any images, photographs, video and/or audio recordings of me and any and all of my activities during the scholarship application process, whether submitted by me or taken or recorded by the Foundation, and hereby authorize the Foundation to use my name, voice, images (still or video), likenesses, and biographical material relating to me in any manner or medium whatsoever for any and all promotional materials relating to or for the Foundation without payment of any kind or any other consideration provided to me. For purposes of this provision, promotional materials include, without limitation, any newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, articles, press kits and submissions to journalists, websites, social networking sites and other print, media and digital communications. This authorization extends to any and all media or formats, whether analog, digital or other, now known or hereafter developed, including, but not limited to, print, radio, television, other audio-visual and audio works, Internet, broadband platforms, mobile platforms, applications, social media, and any other distribution platforms, now known or later discovered. I waive the right to inspect or approve any finished product in which my name, likeness, image (video or still), voice or biological information appears, including written or electronic copy.*

I Agree

I understand that any false statement, plagiarism, or misrepresentation by me in this application or any of the materials submitted in support of my application will disqualify me from consideration for any scholarship or other consideration by the JL Winston Foundation and will constitute cause for the immediate revocation of any scholarship awarded to me by the JL Winston Foundation.*

I Agree

Electronic Signature*