Family Fund Request Form

Fund Request Form

Overview:

The Family Council Fund has been established by the CCU Family Council to support families of CCU students who have experienced or are experiencing an emergent situation that has created a financial hardship for the family in order to support and respond appropriately to the needs of their current CCU student. Examples of this may include but are not limited to hospitalization of student, student illness, death of loved one, etc.

The Vice President for Campus Life and Student Engagement will create a small committee to include a representatives from Financial Aid and the Office of Student Life to review requests and make recommendations for funding.

Demographic Information

Family Member Full Name:

Current CCU Student Full Name:

CCU Student ID:

Family Member Primary Phone:

Secondary Phone:

CCU Email:

Mailing Address:

Statement of Need

In the following box, please answer the following:
(OR you may also upload a word document below.)

Describe in detail your financial need and how these funds will help alleviate your circumstances (attach more pages if necessary) or support your efforts.
Please describe what other efforts you have made to secure funds.
Please attach copies of all available documentation. Documentation may include copies of bills, receipts, application fees, legal notices, etc.

Upload statement answering above statements:

Additional documentation:

Aid Information

Amount Requesting from Family Fund:

Certification of Information

Required

I certify that the information I have provided is true and complete. I will notify the Vice President of Campus Life and Student Engagement by letter immediately if after submission of this application there is any change in the information I have provided in this application.