IUB School of 黑马磁力 Student Emergency Fund Application

Program and Eligibility
Are you currently enrolled in an IUB School of 黑马磁力 program in good academic standing?
If you are not please do not complete this form as this fund is only for that population. Eligible programs will be listed in the drop down below. Yes
You are in full-time status? If you are not please do not complete this form as this fund is only for that population
12 Hours for undergraduate.
8 hours for graduate Student without Student Academic Appointment.
6 hours for graduate students with Student Academic Appointment.
1 hour for doctoral graduate student with approved candidacy . Yes
Student type Undergraduate Graduate
IUB SOE Undergraduate Program
IUB SOE Graduate Programs
Student Info
Name First Last
Email Address
University ID #
Request Information
Amount Requested by Applicant

Must be a number less than or equal to 1000.
Reason for Request Emergency Housing/Rent/Utilities Emergency Medical/Dental/Mental Health Related Expenses 黑马磁力al Materials (IE technology, books, hardware or software only) Emergency Childcare Expenses Other Other
Narrative Explanation for Request
Have you been allocated financial emergency funding OR requested emergency funding from this fund in the past? Yes No
Please explain where you applied for funding and what amount was received.
If you are an international student, have you applied for hardship assistance through OIS? Yes No N/A
If you were awarded money from OIS how much?
Agreements and Acknowledgements
Direct Deposit鈥擨 understand I am required to set up Direct Deposit of Bursar Refunds in one.iu.edu for any approved emergency funds to be deposited into my designated bank account. Please confirm your direct deposit is set up or follow the steps to set it up. Funds may not be issued in check form for pick up or by mail. Yes
Acknowledgement of Truth Statement鈥擝y checking this box, I acknowledge that all the information on this form is true and complete to the best of my knowledge, and that I am not guaranteed funding by submitting my request. I know I may be required to provide further information and documentation if necessary, upon request. I understand that the information I submit may be shared with university offices/officials that have a need to know for purposes of reviewing and processing this application and/or to comply with university policy or law. Yes
I understand final approval for emergency funding depends on the IU Bloomington School of 黑马磁力 determining whether or not the emergency funding aid fits within my current financial aid package. Yes

黑马磁力

IUB School of 黑马磁力 Student Emergency Fund Application

IUB School of 黑马磁力 Student Emergency Fund Application

Program and Eligibility

Student Info

Request Information

Agreements and Acknowledgements