Fillable Financial Hardship Scholarship Application 2021-2022

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Financial Hardship Scholarship Application 2021-2022

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The Financial Hardship Scholarship Application 2021-2022 form is 3 pages long and contains:

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  • 34 check-boxes
  • 15 other fields

Country of origin: US
File type: PDF

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Page 1 of 3
June 2021
Financial Hardship Scholarship Application
2021-2022
About the scholarship:
The purpose of the OSU-Cascades Financial Hardship Scholarship is to assist students who may have experienced sudden,
extreme
circumstances or life events. This funding is being provided to help ensure that OSU-Cascades
s
tudents
wi
th
demonstrated
financial need are able to continue their education.
If you have been impacted by loss of wages or caring for yourself or others, you may be eligible for the financial hardship
scholarship. In your application, please describe the financial crisis you are experiencing and its potential impact to
your ability to continue your studies at OSU-Cascades.
Please review the eligibility criteria listed below. Exceptions to eligibility criteria may be considered. Scholarship will be
awarded in a timely manner until allotted funds have been depleted. The awards range from $350 to $1,000 per award.
Student must meet ALL of the following requirements to be considered for OSU-Cascades Financial Hardship Scholarship:
Must be a degree-seeking student;
Must be an OSU-Cascades student in good standing;
Must be enrolled in at least 6 credits at OSU-Cascades for the term of the funding;
Must have a current FAFSA or ORSAA on file;
Must have received all possible financial aid or other financial resources before applying for this scholarship
(grants, student loans, college savings accounts, etc.);
Must have unexpected financial expenses due to circumstances beyond their control.
Application process:
• This is a fillable form. You must download it first to complete, sign, and submit it electronically.
• Please follow the instructions carefully, complete the application to the best of your ability and email all
pages from your ONID account to financialaid@osucascades.edu.
• The scholarship committee may request additional information or supporting documentation.
• Funds are limited. Applicants will be reviewed on a first-come-first-serve basis.
• Applicants will be notified of the final decision and any necessary next steps via ONID email.
Important Application Note:
• The application must be completed and submitted by the student.
• OSU-Cascades academic advisors, instructors, faculty, staff, parents, and/or legal guardians are not permitted to submit
this application on behalf of the student.
• Priority will be given to students who have not yet received a financial hardship scholarship.
Page 2 of 3
June 2021
FERPA
EMERGENCY GRANT RELEASE OF INFORMATION
In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), I, the undersigned, hereby give my
consent to Oregon State University to release education records or personal information to individuals or entities to whom
I have applied for a scholarship or who have awarded me a scholarship ("Recipients"). I consent to the disclosure of any
and all education records and personal information that is needed by Recipients to evaluate, award, renew, update,
maintain or administer my scholarship or scholarship application. These records and information may include, but are not
limited to, application information (resume, letter, etc.), GPA, year in school, financial need, and major field of study.
Personal information may be re-disclosed by Recipients only as needed for their own stewardship or grant request
purposes and will otherwise remain confidential. My name, image, and directory student information may be shared in
any media release publicizing the scholarship. I understand further that:
1. I have the right not to consent to the release of my education records and I understand that my refusal to
consent may jeopardize my eligibility for some scholarships;
2. I have the right to receive a copy of such records upon request;
3. This consent shall remain in effect until revoked by me.
Submissio
n of this scholarship application confirms my choice to consent to, or to withhold my consent from, this FERPA
Release.
THIS INFORMATION IS RELEASED PURSUANT TO THE CONFIDENTIALITY PROVISIONS OF FERPA AND OTHER
APPROPRIATE STATE AND FEDERAL LAWS AND REGULATIONS, WHICH PROHIBIT ANY FURTHER DISCLOSURE OF THIS
INFORMATION WITHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE
PERMITTED BY SUCH REGULATIONS.
I indicate wh
ether I consent to the FERPA information release by my choice to give, or withhold, my authorization:
I have read and agree to the above terms and conditions.
I Give Consent
I Withhold Consent
Print Name: _______________________________________ Student ID Number: _____________________________
Signature: _________________________________________ Date: __________________________________________
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Page 3 o
f 3
June 2021
GENERAL STUDENT INFORMATION
(This is a fillable form)
___________________________________________________ _______________________________________
Last Name
First Name MI Student ID Number
___________________________________________________ _______________________________________
Street City State Zip ONID email
Are you enrolled or will you be enrolled at OSU-Cascades for the
term in which you are requesting the financial hardship scholarship?
Yes No
Have you submitted FAFSA or ORSAA for the current academic year?
Yes No
Are you currently receiving financial aid and/or scholarships?
Yes No
Is this your first time applying for the financial hardship scholarship?
Yes No
Are you requesting assistance due to COVID-19?
Yes No
Has anyone in your household lost a job?
Yes No
Whose employment was affected? Select a
ll that apply.
Student/Self
Spouse
Guardian/Parent
Other (please explain): _______________________
Was the job lost or hours reduced?
Lost
Hours reduced
What was the hourly or monthly wage?
Hourly Hours per week
Monthly
Please indicate dollar amount needed.
FINANCIAL NEED
Please describe the financial hardship you are experiencing and how you can benefit from the financial hardship scholarship.
If your financial need is related to COVID-19, please describe any and all impacts. Limit your response to 300 words or less.
I am requesting a financial hardship scholarship based on the true and accurate information provided above.
Student Signature: _____
_____________________________________________________ Date: _____________________________
How did
you hear about the financial hardship scholarship?
Academic Advisor
Instructor/Faculty
Student Services Staff (Enrollment/Financial Aid)
Another Student
Other:
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Financial Hardship Scholarship Application 2021-2022

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Completed 20 December 2021

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