Student Emergency Fund

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Student Information

Full Name

Class year

Wentworth ID Number

Pronouns

Cell phone number

Wentworth email address

Major

Questions

Do you live On-Campus or are you a Commuter Student?(Required)

Live On-Campus Commuter Student

You must make at least one selection.

What type of assistance are you requesting? [check all that apply](Required)

Textbooks

Online access codes for class

Supplies for class/project

Food

Transportation

Emergency Housing

Other

You must make at least one selection.

Please provide a description of your financial need. You can choose how much detail you would like to include here. A member of the Dean of Students Office may follow-up with questions or requests for additional information.(Required) This field is required.

If you selected assistance with textbooks or online access codes, please list course name and number, assigned faculty, complete textbook title, and ISBN#. If there is a specific edition required, you need the E-text version of your book, or if a textbook is a package (comes with both the book AND software/access code), please ensure that this information is included. This field is required.

If you selected assistance with supplies for class/projects, please list what those supplies are that you are requesting. Please include as much detail as possible - including links to required items from suppliers (Amazon, Staples, Blick). This field is required.

What address would you like us to use for direct mailing of your items? Please include the name you'd like used for the packages.(Required) This field is required.

Supporting Documentation

If you have any documents that you feel would be helpful for the Student Support Specialists to have when reviewing your request, please attach those. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Student Information

Questions

Supporting Documentation

Submission