Division of Student Affairs Western Carolina University Student Emergency Fund Return form to Student Affairs, 114 East Scott Hall. Call 828-227-7147 with questions. Purpose: The Western Carolina University Division of Student Affairs Student Emergency Fund is limited financial assistance for students who are unable to meet immediate, essential expenses because of a hardship related to an emergency situation. The dollars provided through this fund are not a loan; however, students receiving support are encouraged to repay the fund to the extent possible so that other students may also benefit during their times of need. Funds are counted as income and may be subjected to income taxes. Information will also be shared with Financial Aid if applicable. Eligibility Requirements: • Be a currently enrolled residential or commuter student (undergraduate or graduate) at Western Carolina University. • Be able to document that the Student Emergency Fund is not the only resource being and/or that has been considered to resolve the hardship. • Be able to provide reasonable documentation of the hardship (i.e., bills, receipts, quotes, etc.) from credible sources. • Be in good standing (including, but not limited to academic, conduct, etc.) with the University. Hardships: To include but not limited to: • Natural disasters • Fire damage or need for temporary housing • Medical emergency • Travel emergency • Accidents Supporting Documentation: To include but not limited to: • Medical bills • Estimates for repairs • Documentary evidence (photographs or videos) • Letters of support (usually witnesses of your need) • Financial information • Expert evaluations • Receipts Application Procedure and Information • Contact the Office of Student Affairs at 828-227-7147 or obtain a copy from http://www.wcu.edu/6974.asp. • Fill out application and supply appropriate documentation and submit to the Office of Student Affairs located at 114 Scott East. • Committee decision within 48 business hours. • If approved, the money will be distributed in the form of a university check within 48 business hours of committee’s decision. Professional Judgement: Decisions regarding distributions of monies from the Student Emergency Fund will be made on a case-by-case basis by the Student Emergency Fund Review Committee. Award: • If awarded you will be encouraged to repay the amount received. • If awarded you will be required to submit proof that funds were used as originally requested. If funds are not used as originally requested, you will be required to repay the amount received. Questions: For additional information about the Student Emergency Fund contact the Division of Student Affairs at 828-227-7147. Additional Information: • Further assistance may also be available through various Jackson County agencies. Signature of Applicant Date Division of Student Affairs Western Carolina University Student Emergency Fund Return form to Student Affairs, 114 East Scott Hall. Call 828-227-7147 with questions. Name: 920#: Current Address: Local Address: Phone: E-mail: Date of request: Amount of Request: Please answer the following items to help us understand your situation: 1. Are you currently employed? No Yes (How many hours?) 2. What other agencies or organizations have you applied to for assistance? 3. Are you currently receiving financial aid? No Yes If yes, what types(s)? Please describe the situation in your own words. Include what expenses the emergency fund would be used for, the amount of funding requested, and what documents you will be providing (i.e. medical bills, letters of support, financial information, estimate of repairs, etc.). Also, please share anything else that you feel is relevant to support this request: Would you be willing to allow us to share your story in future student emergency fund fundraising efforts (without using your name or other identifiable information)? (This will not impact the status of your application). No Yes The Committee will review your application and notify you of a decision within 48 business hours. If approved, the money will be distributed in the form of a university check within 48 business hours. If awarded you will be encouraged to repay the amount received and required to submit proof that funds were used as originally requested. ____________________________________________ _____________________ Office Use Only: GPA_____________ Classification____________________ Received Funds Previously__________ Amount if Received____________ Dated Received_______________ ________________ ________________ Date Signature of Applicant ____________________________________________________________________________________________ Approval Date__________ Denial Date___________ Amount Granted________ Date Check Received___________ _____________________________________________________________________________________________________