APIA Scholars: Emergency Fund Application

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Page 1

Eligibility



Scholar Information




MM/DD/YYYY
Contact Information



Mailing Address
Please provide the address where you would like any potential funds to be sent





Page 2

Application Type

Emergency Grant








Federally Declared Natural Disasters






Upload Documentation
Please upload verifying documentation from a third-party source for the specific amount you are requesting. Your supporting documents should demonstrate what category you are requesting assistance with and the total amount you are requesting. Whenever possible, provide a bill, receipt, invoice, estimate, lease or third-party cost estimate.

Examples of appropriate documentation:

  • Overdue utilities bills or shut-off notices
  • Risk of eviction notice
  • Medical and dental bills
  • Emergency services report due to fire or other natural disaster destroying living quarters
  • Police/campus police report of theft of computer, books, clothing or other essential belongings
  • Childcare invoices for legal dependents
  • Copy of lease or a notarized letter if informal agreement for individuals trying to resolve housing insecurity or homelessness
  • Automobile/mechanic expenses if car has broken down
  • Letter from previous employer if recently unemployed and seeking assistance in paying for food, transportation or other necessities
  • Invoice from campus bookstore if asking for assistance in paying for textbooks
  • Travel cost estimate and obituary or other notice if requesting assistance to travel home due to
  • illness or death of immediate family member

The examples above are only showing some possible ways to verify the expenses you need support with and there may be other ways to document. If you are having issues determining what to submit, please email connect@apiascholars.org and we will assist you.









If you need to provide more documentation than the spaces provided, please email connect@apiascholars.org and we will assist you.

Page 3

Disbursement Information

Please Note
Physical checks will be mailed to the address you provided in this application. Please confirm the mailing address you provided can receive physical checks. 

Please be aware that physical checks take longer to disburse. It may take up to 2 weeks for our team to process and disburse physical checks.
Please Note
APIA Scholars utilizes Bill.com to facilitate electronic payments to scholars. If your request is approved, please keep an eye out for a link from Bill.com to set-up an account to receive funds.
Terms and Conditions
By submitting this form, you agree to use any funding awarded solely for the category for which you applied and have been approved for. You acknowledge that any potential tax implications in accepting these funds are your sole responsibility to determine and follow all rules and regulations in accordance with applicable tax laws. APIA Scholars does not provide any tax guidance. APIA Scholars is not responsible for any damages or claims that result from your receipt or use of this funding. 

You understand you will be required to submit receipts demonstrating how any funds awarded were used. You must ensure submitted receipts reflect the amount given as closely as possible and are itemized demonstrating your use of funds for the approved purpose. Funds explicitly designated towards providing food assistance are exempt from this requirement. Funds explicitly designated for disaster relief are also exempt from this requirement. You understand it is your responsibility to submit the appropriate receipts to APIA Scholars in a timely manner after receiving and using the funds. 

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