Student Success | Frog Family Crisis Funds Application

First Name *

Last Name *

TCU ID *

Place a check next to each of the following statements noting your agreement. Application materials that conflict with these agreements will cause a delay in committee review. *

I have completed at least one semester at TCU, and I am currently enrolled full-time.

I have attached all receipts or statements for expenses that have already occured.

I am requesting funds for eligible expenses as described previously on this application, and I am not requesting funds for any of the following: tuition, lab fees, test fees, insurance, non-essential utilities.

Due to NCAA regulations, athletes on full scholarship are not eligible for the Student Emergency Fund. I am not an athlete on full scholarship from the university.

I have clearly explained the emergency event(s) that led to my current situation, and I am not applying for funds due to poor financial planning.

I understand that this fund is meant for one-time, short-term crisis situations that prevent my academic success at TCU and cannot sustain me in a situation of on-going lack of resources.

I understand that I must have exhausted all "self-help" options, especially through the Office of Financial Aid and Scholarship, including student loans, regardless of my desire to take out loans.

I understand that this fund is limited and the maximum amount I can recieve is $1000. I may recieve direct funds but if possible TCU will try to pay my costs directly.

I understand that TCU may not be able to meet all of my needs and I must be open to community resources, social services, and solutions such as food pantries or low cost grocery stores, of which a list can be provided to me.

Avoiding late fees, interest and/or being late on a payment is not considered a crisis by this committee unless I can clearly articulate compounding circumstances that equate to a crisis.

Classification *

Undergraduate

Graduate

Medical Student

Brite Divinity Student

Anticipated graduation date *

Major(s)

Hours Currently Enrolled *

Citizenship *

USA

International StudentInternational Student

Please note country of origin if international student

Phone

Email [TCU Email Address Required] *

We are required to coordinate with the Office of Financial Aid and Scholarships. For circumstances other than those of an extremely immediate crisis, you must have met with the Office of Financial Aid and Scholarship to explore options available to you- scholarships, loans, etc. Not desiring to take student loans, if they are available to you, does not escalate your situation to a crisis. What is the date of your last interaction with the Office of Financial Aid and Scholarship? This will be verified as we are in coordination.

Which member of the Office of Financial Aid and Scholarship team did you interact with?

Have you previously been awarded SEF funding? *

No

Yes

Housing *

On-campus (TCU Housing)

Off-campus House or Apartment

Off-campus (Permanent House, i.e. family's home))

Do you currently have any family members, relatives, or roommates living with you?

YesYes

No

How many?

If you answered "yes" above, are you the sole provider? This means you are the primary individual who pays utilities, rent, and other bills for the entire house. *

Yes

No

N/A

Do you have a US bank account where crisis funds could be sent, if granted?

Yes

No

Mailing Address: This will be the address a check will be mailed to should you receive funding, if a check is necessary. This can take a few weeks. It is VERY important that you fill this out accurately. A typo could cause a 40+ day delay in funding.

City

State/Province

Zip/Postal

Place a check next to any items with which you need emergency assistance: (total max $1000 applies) *

Replacement of lost income as a result of an emergency (two week max, max $1000, and proof of lost income required, such as previous paystub)

Rent, essentials, utilities, and/or household related items

Travel or transportation related to crisis

Medical (medications, co-pays, expenses that you are unable to pay with a payment plan).

Food and basic necessities; replacement of belongings due to theft/fire/or similar crisis

Other immediate needs (please specify)Other immediate needs (please specify)

Description, in detail, of catastrophic event/emergency or situation which is causing current financial crisis: *

What will the funding be used for? You are required to include itemized descriptions with prices, amounts, payment due dates, and other pertinent information. *

Please list amounts of all internal and external scholarships, grants, and loans. This includes your current TCU Financial Aid package. *

Is this a request for reimbursement of funds already spent?

Yes (attach receipt(s) at end of application)

No

Are you currently employed?

Yes

No

Is your employment federal work-study?

Yes

No

If yes, how many hours weekly?

Average monthly earnings:

If no, list reasons for not seeking employment: *

Please list all employers:

Please list all campus and/or community involvements and other time commitments:

Please list other funding resources that you have considered (family, additional student loans, credit cards):

Please provide any additional information that you feel the committee should know. Providing as much information as possible gives the committee a more complete picture of your financial situation.

Referred by:

Please tell us how you heard about this fund

REQUIRED: ATTACH recent paycheck below. For loss of income requests, proof of average biweekly/monthly pay is required. If self-employed attach other proof of income. For other requests, attach bills, receipts, and additional information here.

Maximum file size: 52.43MB

By typing my name below, I certify that answers that answers given herein on this application are true & complete. I give permission for committee members to speak with necessary TCU departments to verify the information provided, & I understand I may be asked to meet with the committee as necessary. I also understand that any fraud or intentional deception on the part of the applicant can lead to university & criminal charges, and I acknowledge that I will be held responsible for reimbursing funds if awarded should there be evidence that my statements are not true and complete. If not attached in my application, I agree to provide receipts or other documentation as requested within 30 days of receiving funds.

Please type your full name and date.

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