Student Emergency Fund Support Request

How to Apply?

To apply, students must complete the Student Emergency Fund Support Request form below which will determine their level of financial need. Supporting documentation will be submitted as evidence of the level of financial need in the form of outstanding bills, bank statements, book list, proof of income, and receipts. Students will also be given a brief interview.

Eligibility Criteria

Students are eligible to apply for the Student Emergency Fund if you meet the following criteria:

Pursuing an undergraduate or graduate degree on a part-time or full-time basis at Nipissing University;
Registered and remain registered in courses during the semester that the application to receive funds through the Student Emergency Fund has been submitted;
Provided proof of greater expenses than available income;
Demonstrated hardship or extenuating circumstances that have resulted in a financial crisis; and
Submission of application to the Student Emergency Fund and any requested supporting documents.

Applicants should be in good financial standing with Nipissing University (no overdue funds owing to Nipissing University). Students are normally permitted only one emergency funding application in their academic career at Nipissing University.

Personal Information

Contact Information

Student First Name

Student Last Name

Student ID Number

Student Email Address

Home Telephone Number

Mobile Telephone Number

Mailing Address

Street Address (Line 1)

Street Address (Line 2)

City

Postal Code

Province

Residence Address (if applicable)

Residence Complex

Apartment Number

Suite Number

Student Information

Program of Study

Year of Study

Have you applied to receive funding through the Student Emergency Fund in the past?

Yes

Have you received funding through the Student Emergency Fund in the past?

Yes

Request Information

Please provide a description in detail of the circumstances that have led to your need to apply for the Student Emergency Fund. Please note you may be required to provide supporting documents (receipts, financial statements, bills etc).

Budget Statement

Once your application for the Student Emergency Fund has been received by Student Development and Services and reviewed by a Student Success Coordinator, you may need to provide an additional budget statement highlighting income sources and expenses in addition to having a discussion with a Student Success Coordinator.

Protection of Privacy

The personal information on this form is collected under the authority of the Nipissing University Act, 1992. It is related directly to and needed by the University to provide services to students in the course of their studies while at Nipissing University. If you have any questions or concerns about the collection, use and disclosure of this information please contact Student Development and Services at Nipissing University, 100 College Drive, North Bay ON, P1B 8L7, (705) 474-3450 ext. 4493.