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Emergency Assistance Request Form


Gaston College recognizes that our students may encounter obstacles that can impact their ability to be successful in college.  Thankfully, because of the contributions of private foundations, community members, faculty, and staff, the Gaston College Foundation has emergency funds to assist Gaston students who experience unexpected or unavoidable hardships. Expenses covered by the Emergency Assistance funds include, but are not limited to, tuition, books, academic supplies, and living expenses (rent, mortgage, utilities, gas, car repairs, and childcare). To be eligible for emergency funding, you must be enrolled in the current term and assistance is limited to once a semester. Please note, funding availability may limit the financial support you are eligible to receive; your application does not guarantee assistance. Once your request is received, a staff member from the Student Development and Support Services Department will contact you via your Gaston College email account.  Please check your Gaston email frequently.  

 
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Student Information

Involved party 1

Questions

Which of the following do you need assistance with? Check all that apply.(Required)
You must make at least one selection.
This field is required.
This field is required.
Have you previously applied for emergency assistance at Gaston College?(Required)
You must make at least one selection.
This field is required.
Did you complete the FAFSA (Free Application for Federal Student Aid) for the current academic year?(Required)
You must make at least one selection.
Were you awarded financial aid?(Required)
You must make at least one selection.
Did you apply for scholarships?(Required)
You must make at least one selection.
Are you currently employed?(Required)
You must make at least one selection.
Are you employed full-time or part-time?(Required)
You must make at least one selection.
This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
Would you like us to connect you with Counseling Services for assistance with stress, anxiety, depression, or other support?(Required)
You must make at least one selection.
Are you experiencing any basic needs challenges such as food insecurity (hunger or access to adequate food); housing insecurity (homelessness, couch surfing, or access to safe, stable housing); adequate clothing; access to medical services; and access to hygiene products?(Required)
You must make at least one selection.
If yes, would you like us to connect you with campus and/or community resources?
You must make at least one selection.
This field is required.
This field is required.

Supporting Documentation

Please attach all documentation that supports your need for emergency assistance, including, but not limited to, the following: Tuition Assistance (Tuition bill or account balance document); Textbook Assistance (Course syllabus listing requirement and proof of required textbook cost); Academic Supplies (Course syllabus listing requirement and cost for supplies, immunizations, fingerprints, etc.); Living Expenses (Billing statement related to rent/mortgage, utilities, transportation, gas, car repairs, and childcare). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission