Wufoo
Owen Emergency Student Fund Application
Students meeting the eligibility criteria for the Emergency Student Fund must complete an application to be considered. All funding requests for expenses incurred will be reviewed and processed by a four-member staff committee in a timely fashion, within 1-2 weeks of submission. Applications will be accepted on a rolling basis as funds remain available. To respect the personal nature of this process, requests will be kept strictly confidential. Applicants will be notified of the committee’s decision via email. Administered by the Finance and Administration Team, all approved funding will be credited to your student account first and provided via direct deposit or, if you do not have direct deposit, will be mailed to your home address.
Primary Contact Name
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First
Last
Vanderbilt Email Address
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Preferred Phone Number
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Total Amount of Funding Request
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$
Dollars
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Cents
Date(s) of Incurred Expense
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MM
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DD
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YYYY
Date(s) of Incurred Expense
MM
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DD
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YYYY
Date(s) of Incurred Expense
MM
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DD
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YYYY
Brief Description of Incurred Expenses
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Supporting Receipts or Documentation for Expenses Incurred (The Finance Department may ask you to supply additional documentation, if necessary, associated with the expenses you have identified.)
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