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Emergency Financial Aid Application
Revised: 04/27/2020
Name: __________________________
Student ID: ________________
Address: ____________________________________________________________________
Have you incurred any expenses related to the disruption of campus operations due to
coronavirus? Check all that apply;
□ food
□ housing
□ course materials
□ technology
□ health care
□ child-care expenses
□ other
o Please describe if you indicated “other”
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Certification
By signing this application, you certify that the information reported is accurate. You
understand that if you are awarded funds, they will be sent to the address on file with the
Registrar’s Office. Any funding received will be used for expenses related to the disruption of
campus operations due to the corona virus as indicated above. Submission of this application
does not guarantee funding. Upon approval, you will receive an email of how and when to
expect funding.
___________________________ ________________________________
Student Signature Date

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Pitt Community College CARES Act Funding Student Application

  • 1. Emergency Financial Aid Application Revised: 04/27/2020 Name: __________________________ Student ID: ________________ Address: ____________________________________________________________________ Have you incurred any expenses related to the disruption of campus operations due to coronavirus? Check all that apply; □ food □ housing □ course materials □ technology □ health care □ child-care expenses □ other o Please describe if you indicated “other” ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Certification By signing this application, you certify that the information reported is accurate. You understand that if you are awarded funds, they will be sent to the address on file with the Registrar’s Office. Any funding received will be used for expenses related to the disruption of campus operations due to the corona virus as indicated above. Submission of this application does not guarantee funding. Upon approval, you will receive an email of how and when to expect funding. ___________________________ ________________________________ Student Signature Date