Emergency Fund Application

PID

First Name

Last Name

Local Phone Number

Local Address

Address Line 1

Address Line 2

City

State

Zip Code

Permanent Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Have you filed a FAFSA for this academic year?

Yes

Were you awarded any financial aid and how much?

Were you offered student loans?

Yes

Did you accept the student loans (in part or all)?

Yes

**If you are currently receiving financial aid, please be aware that receiving funding from the Emergency Fund may affect your future aid package.

Have you received funds from the Student Emergency Fund through the Dean of Students office before?

Yes

Date and Amount

Amount of funds requested from Emergency Fund (Funds do not generally exceed $500)

Please explain in detail the reason why emergency funds are needed and what funds will be used for.

Priority will be given to students whose tenure at UNC-Chapel Hill may be at risk because of unexpected expenses.

* You may continue your explanation on a separate sheet of paper if needed. (Emergencies are defined as unmet individual basic needs of food, safety and shelter, and critical needs to continue in school that are unmet by your financial aid package and after you have exhausted all other possible resources, including the option of loans)

**For full consideration attach copies of all supporting documentation. Documentation should include copies of bills, receipts, legal notices, etc.

***Expenses not covered: tuition and fees, study abroad costs, non-essential utilities, parking tickets, non-emergency travel, etc.

Supporting Documentation

Choose File

Explain how this need impacts your ability to remain enrolled at UNC-Chapel Hill.

Please describe your efforts to obtain assistance to address your needs through other sources (family, friends, campus/community organizations, etc.).

Completion of the below question does not impact decisions related to your application for funding and is voluntary.

Please select the highest level of education completed by your parents/guardians.

By clicking “SUBMIT” I certify that the information I have provided is true and complete. I acknowledge that the information submitted will be shared with the Office of Scholarships and Student Aid so that my application and eligibility can be reviewed by both offices. I will notify the Dean of Students office in writing immediately if, after submission of this application, there is any change in the information provided. I understand that falsifying or withholding information in this application may result in a referral to the Honor system.

Emergency Fund Application

Final Exam Excuses and Absences

To change an exam date due to personal Emergency, family emergency, or Religious Observance :

To change an exam date due to three or more exams within 24 hours, or two exams at the same time: