Dean of Students Emergency Fund Application

Background Information

Please make sure to fill out all background information.

Your full name:

Student ID Number:

Your phone number:

Your UI email address:

Email address must be of a valid format.

Learn more

Please provide your email. Example: herky-hawkeye@uiowa.edu

Your current local address:

Questions

Nature of Emergency(Required) This field is required.

Amount Requested(Required) This field is required.

Are you currently receiving Financial Aid/Scholarships?(Required) This field is required.

What other sources of funding have you tried to obtain? Please explain in detail any other funds you have requested or are currently applying for through campus or community resources. (Students must exhaust all possible options, including student loans, Medicaid, personal financial accounts, community resources, etc., prior to applying for DOS Emergency Funds) This field is required.

Date Funds are Needed(Required) This field is required.

How will the funds be used?(Required) This field is required.

Please explain the impact of this emergency and these unexpected expenses on your ability to remain enrolled at the University of Iowa.(Required) This field is required.

Do you also need assistance for food and meals through the Hawkeye Meal Share Program?(Required)

Yes No Unsure

This field is required.

Were you employed? If so, was this an on or off-campus job?(Required) This field is required.

Is your request related to concerns about an inability to work at your on-campus job? If yes, have you consulted with your supervisor about options and availability of re-purposing your work or working remotely? Please explain.(Required) This field is required.

If you were a student employee on-campus, you received an email regarding pay options from the University. In the email, it shared: • If you are an employee with a fixed term of employment, such as a resident assistant, you will continue to be paid as normal through the end of the term of your employment. • If you are an hourly employee paid bi-weekly, including student employees, and are unable to work because of this public health emergency, you will be paid for up to 80 hours of time based on the hours you would have expected to work this semester. Federal work-study will continue to be paid, in keeping with the Federal Work Study Electronic Guidance. If you have any questions about this, please speak with your supervisor or your Human Resources representative. Given this information about pay, do you still want to be considered for the emergency fund?(Required) This field is required.

Supporting Documentation

Please provide any supporting documentation you believe is important for your application for DOS Emergency Funds. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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Background Information

Questions

Supporting Documentation

Submission