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BAYLOR PARENTS NETWORK STUDENT EMERGENCY FUND
AWARD APPLICATION
Legal name _______________________________________________________________________________________
Last
First
Middle
Baylor ID number ____________________________________ Cumulative Baylor GPA ___________________________
Baylor email address ________________________________________________________________________________
Anticipated graduation date __________________________________________________________________________
Cell phone number ____________________________________ Home phone number ___________________________
Current local address ______________________________________________________________________________
Street
______________________________________________________________________________
City
State
Zip
Amount requested $________________________
Description of emergency_____________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
I certify that the above information is true and accurate and I agree to furnish receipts and/or other documents requested in support
of this application. In addition, I understand that submission of this application does not guarantee that additional assistance will be
awarded. Further, I understand that if I make any false or misleading statement(s), this could result in referral to Baylor's Judicial
Affairs Office for violating Baylor's Student Conduct Code.
Applicant signature ________________________________________ Date _______________________________
Submit completed application and supporting documentation to: Student Financial Aid Office
One Bear Place # 97028
Waco, Texas 76798-7028
financial_aid@baylor.edu
FOR OFFICE USE ONLY
Reviewed by______________________________________
Approved __________ Amount $__________________________________
Approved by ______________________________________
Denied ____________ Reason denied ______________________________