Financial Aid Office

Emergency Grant-In-Aid — Request Form

1. Applicant Info (required)

First Name:

Last Name:

Email:

Phone:

2. Enrollment Info (required)

Department:

School:

Degree:

Year of Study:

3. Family Info (required)

Marital status:

Name of spouse/partner (if applicable):

Spouse or Partner employment/academic program (if applicable):

Dependents (living with applicant):

1. Name of dependent (if applicable):

1. Age (years):

1. Relationship to student:

1. School/employer:

2. Name of dependent (if applicable):

2. Age (years):

2. Relationship to student:

2. School/employer:

4. Reasons for Your Request (required)

Provide a brief explanation of the reasons for your request and lack of other resources to meet this expense. Eligible expenses include unanticipated or unusual expenses (most commonly medical or dental but other expenses can be considered) that are outside of the typical student budget that may hinder your academic progress. For long explanations or multiple detailed circumstances you may upload a document that includes your full explanation. You can omit writing your information in the below section.

Explanation:

5. Additional Questions (required)

Did you complete the most recent FAFSA application?

Yes No

Have you previously applied for the Grant-In-Aid?

Yes No

What is your outstanding educational loan debt today?

6. Grant-In-Aid Breakdown (required)

List the specific expenses for which you are requesting support and attach supporting documentation. Only expenses that occur within the current enrollment period with docmentation can be considered. If you have additional expenses but run out of room on the application you may upload your additional costs through the document upload portal.

1. Date of Expense

1. Item Description

1. Amount

1. Documentation (Describe type and upload in next steps.)

2. Date of Expense

2. Item Description

2. Amount

2. Documentation (Describe type and upload in next steps.)

3. Date of Expense

3. Item Description

3. Amount

3. Documentation (Describe type and upload in next steps.)

4. Date of Expense

4. Item Description

4. Amount

4. Documentation (Describe type and upload in next steps.)

5. Date of Expense

5. Item Description

5. Amount

5. Documentation (Describe type and upload in next steps.)

6. Date of Expense

6. Item Description

6. Amount

6. Documentation (Describe type and upload in next steps.)

7. Date of Expense

7. Item Description

7. Amount

7. Documentation (Describe type and upload in next steps.)

8. Date of Expense

8. Item Description

8. Amount

8. Documentation (Describe type and upload in next steps.)

9. Date of Expense

9. Item Description

9. Amount

9. Documentation (Describe type and upload in next steps.)

10. Date of Expense

10. Item Description

10. Amount

10. Documentation (Describe type and upload in next steps.)

Total Amount

7. Confirm & Upload Documents (required)

Consent

By submitting this financial aid application and uploading documents, I hereby consent to Stanford University’s collection and processing of any sensitive personal data contained in my application and documents to evaluate my application for the other purposes described in Stanford University’s Online Privacy, Offline Privacy Policy, and the Privacy Notice for Admissions and Financial Aid which can be found at privacy.stanford.edu

By entering my Stanford ID number below, I am certifying that all information in this application is accurate and complete to the best of my knowledge.

Student ID:

Today's Date:

Form version:

Leave this field blank

Financial Aid Office

Emergency Grant-In-Aid — Request Form

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