Qatar Harvey Scholarship - Summer and Fall 2019

Dear Student, In an effort support you in continuing with your education at UHD, students who were affected by Hurricane Harvey may qualify for a scholarship for up to $5,000.00 generously supported by the One Star Foundation and Rebuild Texas Fund. The award is to assist you with housing, transportation, computer, books and/or replace lost employment with on-campus work opportunities. Applications will be reviewed on a rolling basis beginning April 12, 2019 through April 26, 2019. All applications are confidential, and for committee use only. 1. Student must be enrolled full time for summer (6+units) and/or fall (12+ units for undergraduate or 8+ for graduate). 2. GPA of 2.0 or higher Priority will be given to students who have exhausted all other forms of aid and/or who are nearing graduation (based on credit hours remaining toward degree).

Applicant Information

Today's Date*

900# or EMPLID*

Please enter your 9-digit student ID Number or your 7-digit EMPL ID#

Anticipated Graduation Term*

Select or enter value

First Name*

Last Name*

Gatormail Email Address*

Personal Email Address*

Preferred Phone Number*

Mailing Address (House Number and Street)*

Apartment Number

Please enter your apartment number (if applicable).

City*

State*

Select or enter value

Zip Code*

Support Requested

I have been impacted by Hurricane Harvey and am requesting assistance with (please check all that apply):

Tuition Expenses

On-Campus Employment

Computer

Books

Housing

Transportation

Other Resources

Total Amount of Support Requested*

Please specify the dollar amount of support requested

Narrative Statement*

Please provide a brief narrative of the requested support, include details on how Hurricane Harvey prevented you from continuing your education.

Certification and Authorization

I hereby certify that all information provided in this application for assistance is true, accurate, and correct. I hereby authorize the release of this information to the review committee for consideration. I further acknowledge that, if I am approved, non-identifying information about my request may be used to inform donors to the Student Gator Relief Fund in communications, and may be used in promotional materials.

e-signature*

Please enter your first and last name below which will serve as your electronic signature for the university to process your request based on the above entries.

Date Certified*

Supporting Documents

File Attachments

Please provide at least one form of supporting documentation. Applications will not be considered complete with out supporting documentation. Some examples include the following: 1. Proof of registration with FEMA 2. Proof of residence at a temporary shelter 3. Proof of insurance claim as a result of Hurricane Harvey 4. Proof of loss of housing, transportation, employment or property 5. Proof of unanticipated emergency, e.g. medical bills, transportation, etc. 6. Other related supporting documentation

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