Emergency Assistance Program

The emergency assistance program allows students the opportunity to access short term assistance in times of need. After completing this application, the Office of the Dean of Students will review your information and may designate a certain amount of resources to you in the form of gift cards, Student 2 Student meal allotments, referrals, and other kinds of financial assistance. Once your application is completed and submitted you will be contacted by a staff member from the Dean of Students Office to set up an appointment. For questions about this program contact us at 205-348-2461. Please complete the following form:

*Date:

CWID:

Full Name:

Email Address:

Current Address:

Phone Number:

Why you need assistance: (Check all that apply):

Tornado Victim

Financial Aid Depleted

Loss of Employment

Loss of Family Source

Medical Condition

Other (Explain)

What type of assistance do you need: (Check all that apply):

Food

Shelter

Clothing

Toiletries, Household Supplies, etc

Other (Explain)