Living Expense Grant Application
Please complete the application in its entirety and do not leave items blank. Additional sheets may
be attached as needed.
Name ATC ID# Marital Status
Address City State Zip
Cell Phone Home Phone Email Address
Program of Study Expected Date of Completion
Are you a? Veteran Active-Duty Service Member Reservist
Are you receiving VA Education Benefits or Federal Tuition Assistance (TA)? Yes No
If yes, which benefit type? Post 9/11 Chapter 30 Chapter 1606 Reservist
TA Voc Rehab
Are you receiving Federal Aid - Pell Grant/Student Loan(s)? Yes No
If so, list all sources of aid you currently receive.
1) Are you employed? If yes, Full-time Part-time
2) Do you currently own (or are purchasing), or rent your home? Own Rent
3) Are you or your spouse (if applicable) currently receiving any government-funded aid to help
with living expenses? If so, list aid you are receiving.
(Complete other side)