Emergency Grant Application

STUDENT INFORMATION

SCHOOL INFORMATION

Current School:
Category of Aid:

By submitting this emergency grant application, I acknowledge and give consent for data to be shared with the Department of Education and Trellis Company, or their representatives, as part of Project Success. I understand that my information will not be sold for any purpose and will not be distributed to other parties. Examples of data share include, but not limitied to: student name and ID, enrollment status, annual income, EFC, emergency request amount, emergency request type, etc.

This form is still under development.