Assumption Coronavirus Relief Aid Application

Fall 2020 Entering First-Year and Transfer Students

As a result of coronavirus, Assumption University recognizes that many families are struggling financially due to job losses and/or a reduction in wages. If your family has experienced a financial setback as a result of the coronavirus, Assumption University may be able to assist you.

The Assumption University Financial Aid Appeal Committee will review these applications on a first come, first served basis to determine if additional, one-time grants for the 2020-2021 academic year can be awarded as a way to ease your family’s financial burden as it pertains to financing a college education. Please note that completion of this application does not guarantee additional funding will be provided.

Student Legal First Name*

Student Legal Last Name*

Student Email (Please use the address where your student receives emails from Assumption)*

Confirm Student Email*

Parent Email*

Phone Number*

Student Birthdate*

Student Mailing Address*

Country

Street

City

Region

Postal Code

Please indicate how your family has been financially impacted by the Coronavirus (please select all that apply)*

Job Loss - Parent

Income Reduction - Parent

Other

Name of parent with job loss*

Name of position/industry*

Name of second parent with job loss

Name of position/industry

Name of parent with reduced income*

Name of position/industry*

Name of additional parent with reduced income

Name of position/industry

Other*

Monthly Income, Benefits, & Resources

Please itemize your custodial parents’ monthly income prior to Coronavirus as well as your best estimates for the 2020-2021 academic year so that we can better understand how these financial changes are impacting your family. PLEASE LIST DOLLAR FIGURES PER MONTH - ENTER 0 IF NOT APPLICABLE.

Monthly Income, Benefits, and Resources (Gross) Pre-Coronavirus

Wages*

Welfare Benefit*

SNAP/Food Stamps*

Housing Subsidy*

Cash Support*

Social Security*

Child Support*

Alimony*

Unemployment*

Pension Distributions*

Rental Income*

Other Taxable Income (dividend, self-employment, etc.)*

Untaxed Income*

Severance Package Funding*

Other - please specify

Other amount

Other - please specify

Other amount

TOTAL Pre-COVID-19

Monthly Income, Benefits, and Resources (Gross) Currently

Please outline how the Pre-Coronavirus monthly income, benefits, and resources listed above have been impacted.*

Additional Information

If you would like to provide any supporting documentation you are welcome to do so here. Depending on the outcome of your application, Assumption may require additional documentation at a later point (e.g. documentation of unemployment benefits, letter from employer, etc.).

Please use the space below to provide any additional information about the change in your family’s financial circumstances as a result of Coronavirus.

I/we certify that the above information is complete and correct and may require further follow-up from the Office of Financial Aid.

Name of person completing this form*

Person completing this form*

Student

Parent/Legal Guardian