- Supplemental Questions
- First Name (Legal Name)
- Middle Name
- Last Name/Surname
- Preferred Name (If different from above)
- Are you currently enrolled at Seattle Central College?
- SID - Please enter your Seattle Colleges SID number
- Home/Cell Phone Number
- Email Address (Seattle Colleges email preferred)
- Date of Birth
- Academic Plan
- 1. Area of Study
- 2. Select what you plan to earn at Seattle Central College
- 3. If answered "none" in the previous question, please explain your academic plan
- How many credits are you currently enrolled in?
- Are you currently in the Adult Basic Education (ABE) program?
- Are you an international student studying on a F-1 or M-1 student visa?
- Have you ever been in state, tribal, or federal foster care in Washington state, or experienced unaccompanied homelessness?
- Current Employment Status
- Financial Information
- 1. Have you completed a Free Application for Student Financial Aid (FAFSA)or a Washington State Financial Aid Application (WASFA) for the year of 2019-2020?
- 2. If "no," please explain
- 3. Are you receiving any other aid or scholarships?
- 4. If yes, please list other aid and scholarship you are receiving
- Were you referred by any of the following?
- Did you recently experience an immediate or urgent financial emergency?
- If yes, please select the cause of the financial emergency.
- If other, please specify
- Have you applied for this Emergency Funding before?
- If yes, did you receive any funds from this opportunity?
- Please list other resources have you utilized to cover this expense
- Amount of funding requested:
- Please upload supporting documents or directly submit documentation to Student Support Programs (BE3215).
- Upload additional supporting documents as needed
- Please share with us a short narrative of your immediate or emergent financial hardship that will hinder your ability to persist through the quarter?
- Is there anything you would like to add for the committee to consider?
- DISCLOSURE STATEMENT: Please note that your student identification number will be used to evaluate the program partnership, persistence, and completion. Data will only be shared with the State Board for Community and Technical Colleges (SBCTC) and the United Way. All information will be non-identifying and in aggregate form. Your decision to participate in this research will not affect the outcome of your scholarship application.
- AGREEMENT OF UNDERSTANDING:
Participating in the Emergency Fund application process is subject to the following terms and conditions. By signing this agreement, you acknowledge and accept the terms as listed below:
A submitted application will not guarantee that an award will be given. My application will not be considered unless all required materials are attached, and submitted by the deadline. My application is confidential and application materials will not be returned.
All information provided in my application is true and complete to the best of my knowledge.
If it is determined that it contains false, altered or forged information, my application will not be considered and if awarded, the award will be rescinded. Additionally, the misconduct may be reported to the Vice President for disciplinary sanctions under WAC 132F-121-110.
IF AWARDED, I AGREE TO:
Authorize the release of information on this application and other necessary academic information to the Seattle Colleges Foundation, Office of Advancement, selection committee and the Seattle Central College Financial Aid office. Release to Seattle Central College and the Seattle Colleges Foundation the right to use my name publications, reports and press releases.
- Electronic Signature
- Today's date
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