University of Mary Hope Grant Student Eligibility Form

Funds for Student Financial Emergencies

This form should be completed by students only. Faculty/staff wishing to refer a student for assistance with Hope Grant Funds should use the Faculty/Staff Referral Form: https://fs16.formsite.com/assesswow/hmbx7ax1bb/index.html

BEFORE YOU BEGIN: If this is an emergency that involves an immediate risk of harm to self or others, please contact Campus Safety and Security by calling 701-355-8000 from any hardline or cell phone. You also may call 8000 from any campus phone. For any emergency where police, the fire department, or an ambulance is needed call 911.

In order to be eligible for Hope Grant Funds, a student must:

1. Be an undergraduate

2. Be attending class at UMary's main campus

3. Be registered for classes during the term when the hardship occurred

4. Have an expected family contribution of $12,000 or less as determined by completing a free application for federal student aid (FAFSA)

5. Not have previously received Dash or Hope Grant funds through UMary

6. Be applying for a qualifying emergency.

The following expenses are eligible and are considered a qualifying emergency: Child care, food/meals, gas, housing/rent, medical/dental/vision expenses, personal automobile expenses, public transportation, and utilities. Hardships that do not fit into one of these categories still may be eligible for Hope Grant funds subject to a review by the UMary Hope Grant Committee.

The following expenses are ineligible and will disqualify applicants: parking, fines, tuition, textbooks, required tools/equipment/supplies for your program of study, entertainment expenses, and alcohol/tobacco

Name: *

Enter your student ID: * 🛈

UMary email address: *

Please select your current level: *

Undergraduate

Graduate

Phone number where you are best reached: *

Have you previously received emergency funds through UMary? (Dash or Hope Grant) *

Yes

No

Select where you attend the majority of your classes: *

If you have visited with UMary faculty/staff about your financial hardship, please list their names: *

Please select your reason for seeking Hope Grant funds: *

Briefly describe your request for funds: *

Requested amount. *Hope Grant requests subject to reduction based on committee determination and available funding. *

Upload any documentation to support your request (not required for determining your initial eligibility):