Cal Poly Cares Application For Assistance 2021-2022

Cal Poly Cares provides emergency grants to students experiencing unexpected expenses which are impacting their ability to be successful.

Empl ID *

Enter any leading zeros, must be 9 digits

First Name *

Middle Name

Last Name *

Cal Poly Username *

Phone Number *

College *

Major *

Class Standing *

How many units are you currently enrolled in?

Have you been awarded for Cal Poly Cares in the past? *

Yes

There is a limited amount of funding available and priority will be given to students with demonstrated need. Additionally, Cal Poly Cares may not be able to fulfill all requests.

Did you submit a FAFSA or Dream Act Application for the current academic school year? *

Yes

I don't know

Are you an International Student? *

Yes

Are you a student with dependents (i.e. children, spouse, etc.)? *

Yes

Amount of funds requested (Funds generally do not exceed $2000)

Enter the total amount requested * $

For which of the following categories are you seeking assistance? *

To select more than one option press the Command key (⌘) on a Mac or Control (CTRL) key on a PC and make your selections.

Explain in detail the serious and unexpected circumstances beyond your control that have resulted in your financial crisis/emergency.

Explanation of circumstances *

Attach supporting documentation (e.g. travel-related documentation, medical bills, essential utility bills, police reports or court records, receipts or invoices pertaining to covered expenses listed above,etc.)

Supporting documents

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png html pdf doc xls xlsx.

If Cal Poly Cares is unable to fulfill your request, what is your plan to resolve your situation? *

To be eligible for the Coronavirus Aid, Relief and Economic Security (CARES)/Higher Education Emergency Relief Fund provided by the Federal Government please confirm the following (select all that apply): *

I am a U.S. Citizen or eligible permanent resident or meet eligibility for federal benefits

One or more of these doesn’t apply to me, please consider me for Non-federal funding

Please Confirm Your Cal Poly Email *

Leave this field blank

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Cal Poly Cares - Forms

Web Forms for the Cal Poly Cares Program

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