NOTE: If eligible, this is a one-time award and repayment is not required. Funds are limited. Completion of this form does not guarantee funding.
Please answer the following questions so the HEERF Grant Committee understands your exceptional need and related expense with a brief summary of your situation. Incomplete applications will not be considered and will be returned for further documentation.
What emergency expense and its monetary value do you currently have related to the disruption of campus operations due to the coronavirus such as tuition, food, housing, healthcare (including mental health care), childcare, loss of income?
1. Please detail your explanation. (Must provide supporting documentation of the expense such as a third-party statement on official letterhead, copies of furlough or termination papers, pay stub reflecting reduction in wages, unemployment claim, doctor’s note, receipts, etc.) *
2. How will this grant help you get through this emergency? *
3. Are there circumstances of which the HEERF Grant Committee should be aware? *
If awarded a HEERFA III Grant, how would you like the funds to be administered? *
All boxes MUST be checked.