For Ofﬁce Use Only:
FA application on ﬁle Committee review date Approval amount
Date sent to Ofﬁce of the President for authorization Date sent to CCAC Educational Foundation for processing Date funds processed
Complete application and submit through your campus dean of Student Development office.
To be eligible for the CCAC Student Emergency GAP Fund, an applicant must:
• be a current CCAC student enrolled in a minimum of 6 credits and maintain a
minimum GPA of 2.5;
• have completed the college’s financial aid application process;
• be degree or certificate seeking; and
• be in good behavioral and financial standing with the college.
Student’s Name: SS# or ID#:
Home Phone: Cell Phone: Email:
Funding Amount Requested:
You have been asked to complete a Student Emergency Gap Fund application that supplies supporting documentation of the financial or personal
circumstances prompting the application. Please describe the circumstances you are currently experiencing which would be alleviated if you were to receive
Student Emergency GAP funds. Include how the funds will assist you in continuing your education, how the funds will be used, and supply documentation of
cost of expenditures. Attach the required supporting documents which demonstrate this need. Please use additional sheets as necessary.
I certify that the information contained herein is true.
Student’s Signature: Date:
Student Emergency GAP Funds App-CDI-SLK-APR19
COMMUNITY COLLEGE OF ALLEGHENY COUNTY
STUDENT EMERGENCY GAP FUND APPLICATION
Allegheny Campus Boyce Campus North Campus South Campus
808 Ridge Ave 595 Beatty Rd 8701 Perry Hwy 1750 Clairton Rd
Pittsburgh, PA 15212 Monroeville, PA 15145 Pittsburgh, PA 15237 West Mifin, PA 15122
OUR GOAL IS YOUR SUCCESS.