Please complete this request form for the COVID-19 Student Relief Fund – Balance Assistance for Fall 2023. Additional documentation may be required.

The COVID-19 Student Relief Fund is designed as one-time need-based aid to support students’ persistence toward degree completion by addressing unforeseen financial obstacles that could prevent students from progressing as a result of the COVID-19 pandemic. Students can request funds to offset a portion of their student balance owed to Benedict College.

The COVID-19 Student Relief Fund Committee will evaluate each request. All Committee decisions are final. Upon approval, funds will be applied to students’ accounts at the College.

The student requesting aid must meet the following criteria:

1. Be enrolled at Benedict College as a full-time student at the time of the emergency aid request (Graduated seniors are no longer able to apply);
2. Complete the request form and include supporting documentation validating the unforeseen financial need(s).

***Requested amounts may not be approved in their entirety based on availability of funds. ***

Student Name

Date

Address Line 1

Address Line 2

City

State

Zip

Classification

Email

BC ID Number

Valid Contact Number (Including area code)

Reason for hardship (Check all that apply)

Total Requested Dollar Amount (Example: $50.00)

How will this financial assistance contribute to your academic success? (Please be detailed in the description of the need and reason)

Attach supporting documents. This includes billing statements, eviction notices or statement of unemployment.

Document can include screenshots or jpeg files. It is recommended to compile multiple statements in a single Word or PDF document.

*Do not attach png files as they are not supported*

E-Signature: By typing your name you acknowledge that you have read this form in full detail and verify that all statements are true and not falsified.