Step 1 of 3 – Important Information 33% The Emergency Student Assistance Fund is designed to give you a helping hand when life throws unexpected challenges your way. By providing support for one-time, unforeseen expenses, this fund helps you stay focused, continue your studies, and keep moving forward on your path to success at Athens State University. Please read the instructions carefully and complete all sections of the form. Guidelines for requests: • Only emergency, one-time expenses from your current term are eligible. • You must provide documentation (such as a past-due bill, car or home repair invoice, medical bill, or childcare bill) to support your request. Requests submitted without documentation are considered incomplete and may delay processing. • Include the exact amount you are requesting. Requests without a specified amount are considered incomplete and may delay processing. Name First Last Athens State Email (@my.athens.edu) What is your Athens State Student ID number?*Have you applied for financial aid at Athens State University through the FAFSA?* YES NO Are you currently employed?* YES NO If yes, list your average hours per weekDo you currently owe Athens State University money?* YES NO Have you received emergency assistance from the ESA Fund before?* YES NO What dollar amount of emergency assistance are you seeking?In your own words, briefly explain your situation and how this unexpected emergency will prevent you from completing your courses this semester.*If approved, I would like my funds disbursed via:* A check mailed to me A check I pick up in person on the main campus Enter Address Upload documentation that supports your emergency situation.* Drop files here or Select files Accepted file types: doc, docx, pdf, rtf, Max. file size: 10 MB, Max. files: 5. Example copies: past-due bill, unexpected car/home maintenance, letter of termination, medical bill, childcare invoice, etc. By checking this box, I understand: this application does not guarantee my eligibility for emergency assistance and the availability of these funds is limited based on donor contributions. I understand that this is not an immediate process, and that my application will be reviewed by the Office of Enrollment and Student Services, and I will be emailed with further information.* Agree By checking this box, I understand: this application does not guarantee my eligibility for emergency assistance and the availability of these funds is limited based on donor contributions. I understand that this is not an immediate process, and that my application will be reviewed by the Office of Enrollment and Student Services, and I will be emailed with further information.
