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Student Emergency Aid Form
Name
(Required)
First
Last
Student ID Number
(Required)
Date
(Required)
Month
Day
Year
Phone Number
Describe the nature of the emergency:
(Required)
Amount of the emergency:
(Required)
Supporting Documentation Upload
Drop files here or
Select files
Max. file size: 8 MB.
If approved, how would you like to receive your check?
(Required)
Pick up on campus
Mailed to the address you provide
Have you checked with Financial Aid?
(Required)
Yes
No
financialaid@au99168.com or (218) 755-2034
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What other resources have you considered?
(Required)
Have you heard about these other resources? http://4mzi.au99168.com/campus-life/support-services/basic-needs/
If awarded, these funds may be used for one-time emergency support, based on the student being a current Bemidji State University student enrolled a minimum of part-time, and attending classes during the semester request is made. Emergency funds can include but not limited to academic schooling costs (textbooks, tuition, etc.) utilities, legal advice, medical bills, one-time assistance to purchase food, help paying rent or utilities and other legitimate financial needs. Students may not receive greater than the maximum allowed. Funds will be distributed by the Bemidji State University Alumni & Foundation accounting department. Funds may be sent to a third-party vendor, or by check directly to the student. A thank you note by the student receiving the funds is encouraged.
Student hereby verifies they are currently enrolled at Bemidji State University with:
(Required)
Provide number of credits
Referred by (Faculty/Staff)
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