Please enable JavaScript in your browser to complete this form.Student ID *Email *Cell Phone *I certify I was enrolled at least half-time at Bacone College on or after March 13, 2020 in at least one of the following semesters: (check all that apply) *Spring 2020Summer 2020Fall 2020Spring 2021Summer 2021Fall 2021I certify I have incurred expenses related to COVID-19. Please check all that apply: *Cost of AttendanceFoodHousingCourse materialsTechnologyHealth careChild carePlease check all that apply: *I have received federal funding such as Pell, SEOG, Federal Work Study, and/or Direct Students Loans (Title IV funding).I have faced significant unexpected expenses due to loss of employment due to the coronavirus.I have faced significant unexpected expenses due to a reduction of income due to the coronavirus.I have faced food insecurity due to the coronavirus.I have faced housing insecurity due to the coronavirus.Disclaimer: Students have the ability to decline the emergency financial aid grant to pay off debts and instead may use the funds for any component of the student's cost of attendance or for emergency costs that arise due to coronavirus, such as tuition, food, housing, health care (including mental health care), or child care. If this is the case, please email [email protected] Please indicate how you would like apply your emergency financial aid grant: (check all that apply) *I consent to applying my financial aid grant to my tuitionI consent to applying my financial aid grant to my room and boardI consent to applying my financial aid grant to my health care (including mental health care)I consent to applying my financial aid grant to my child care costsPlease explain how COVID-19 has impacted you and/or your family financially. *I agree and confirm by submitting this application for an emergency financial aid grant that: (1) I will use this grant solely for expenses related to the cost of attendance at Bacone College due to coronavirus (including eligible expenses under my cost of attendance, such as food, housing, course materials, technology, healthcare and childcare); (2) I understand the college will prioritize students with exceptional need, such as students who receive Pell Grants or with extraordinary financial circumstances, in awarding emergency financial aid grants to students and I understand other types of exceptional need could include students who may be eligible for other federal or state need- based aid or have faced significant unexpected expenses either for themselves or that would affect their financial circumstances, such as the loss of employment, reduced income, or food or housing insecurity.Signature *Clear SignatureSubmit