Request for COVID-Related Student Emergency Assistance Funds

Your Name*

First Last

Student ID*

TCC Campus*

TCC Email Address*

Phone Number*

Current Mailing Address (must match your address on file at TCC)*

Do you have a child/children under the age of 18 at home?*

Have you submitted a complete federal FAFSA or state VASA?*

Have you currently lost financial aid eligibility because you are not making standard academic progress (SAP)?*

Is this emergency the result of a job loss?*

Have you completed a Single Stop profile?*

You are required to complete a Single Stop profile as part of the documentation necessary to support your request. Please speak with your case manager if you need more information.

Have you previously requested emergency assistance funds during the current academic year?*

Students can apply for emergency assistance funding no more than once per academic year.

Please indicate the SREC Case Manager you are working with:*

Dollar amount requested.*

Funds are awarded based on the amount supported by documentation from the student, not to exceed $2,000 dollars per incident.

Reason for Need*

Please indicate your reason for needing student financial assistance.

Please use the space below to describe the emergency situation that you are requesting assistance with.*

Please use the space below to describe the future financial plan that you discussed with your SREC Case Manager.*

By initialing below, you agree to provide your SREC Case Manager with all required documentation needed to support your request.*

Request for COVID-Related Student Emergency Assistance Funds

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