EmailMe Form - HEERF III CARES Grant Program

Student ID *

Student Name *

First Last

Student ABAC Email *

If you have a balance for the current term, do you give ABAC permission to apply your grant to your balance? Any remaining portion of the grant will be sent to you through your eStallion account. *

Yes

No

If you have a balance for an upcoming term (not a past term), do you give ABAC permission to apply your grant to your balance? Any remaining portion of the grant will be sent to you through your eStallion account. *

Yes

No

If you have a balance for a past term , do you give ABAC permission to apply your grant to your balance? Any remaining portion of the grant will be sent to you through your eStallion account. *

Yes

No

Signature

Clear

I certify the information given above in this application is true. I also give members of the selection committee permission to access my academic and financial aid records for the purposes of determining grant eligibility.

Today's Date/Time *

MM / DD / YYYY HH : MM AM/PM