Student Emergency Assistance Fund Application

Doane University is committed to supporting its students, and understands that life circumstances can sometimes take your focus away from college. Some examples of how this fund could assist you:

Help to pay for college-related expenses following a sudden loss of income
Funding for clothing, school supplies if you have lost housing due to fire, flood or other natural disaster
Assist with the cost of airfare if you need to travel home due to family emergency
Help with living expenses to make a transition out of an unhealthy living situation

Name of person completing application

First Name

Last Name

If you are completing this application on behalf of a student, is the student aware that an application is being submitted?

Information for Doane student needing assistance

First Name

Last Name

Cell Phone

Doane Email Address

Current Mailing Address

Address

City/Town

State/Province

ZIP/Postal Code

Student ID

Student Status

Major / Program

Amount of Emergency Assistance funds requested

Amount awarded will not exceed $500 in most cases.

Please use the space below to detail how the requested amount will be used. Include a description of the expense, to whom the payment will be made, and the total amount requested.

Please explain in detail your current situation and the need for funds. (Include payment due dates as applicable. For example, “I need to purchase textbooks for my Fall 2023 classes by August 25 at the latest in order to keep up with my classes”)

If these expenses will be ongoing, what ideas do you have for how you will cover expenses in the future? (The committee understands that you may not have a defined plan at this time but any information is helpful)

Please describe below any other sources where you have reached out to for funding and any help you are receiving or planning to receive from those sources (family, other campus or community organizations, government assistance, etc.)

By submitting this application:

You certify that the information provided is true and complete.
You agree to notify the application review committee immediately if after the submission of this application there are any changes to the information you have provided.
You agree to submit receipts and/or other supporting documentation requested by the committee in a timely manner to [email protected] for the costs outlined above to show proof of appropriate use of funds.
You understand that this application is a request for assistance and does not obligate the committee to award any funds.
You understand that a member of the committee may call or email you to ask follow-up questions, if necessary.
You understand that the funds come from private donors and while it is not required to write a “thank you” to be eligible, it is greatly appreciated. You will receive guidance on how to do this in the upcoming months.
You understand that you will receive timely notification of the status of your application once it has been reviewed by the committee.