HEERF III Grant Application

Fields marked with a * are required.

All HEERF III Grant Applications and Supporting Documentation must be submitted no later than June 23, 2023 11:59pm for consideration

READ CAREFULLY BEFORE COMPLETING

About the Higher Education Emergency Relief Fund (HEERF): Albright College is committed to supporting student success. In these unusual and unprecedented times, we recognize that students may face unexpected challenges in reaching their educational goals and require a short-term grant to achieve success. The main criterion for this grant is the demonstration of an exceptional need and that the capacity for continued study may be in jeopardy due to financial hardship. Applicants must be able to provide documentation supporting their expense.

This fund intends to provide one- time emergency grants to help students meet current URGENT expenses, such as housing (if displaced due to disruption of campus operations), travel, technology, healthcare, and childcare (must be because of disruption of campus operations) and loss of income.

Eligibility Requirements:

• Student must demonstrate exceptional financial need.
• Students must be enrolled at the start of the 2021-2022 academic year.
• Student must be in good academic standing with the college.

Student Name *

Albright ID *

Phone *

Email *

Address *

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? *
Apply my entire HEERFA III grant to my student account.
Issue my entire HEERFA III grant allocation as a refund.

All boxes MUST be checked.

* By submitting this form, I authorize Albright College to utilize my HEERFA III grant (if awarded) toward my student account balance or issue a refund as detailed above.

* I acknowledge that the above information is accurate, and I understand that a committee will review it to determine my eligibility for emergency funding. I confirm I need these funds to provide for emergency expenses and to be able to continue my education. I understand that these funds are not taxable for purposes of filing taxes.

Student Signature (please type your name in the box below) *

Date *

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