I certify that I am an Active Duty member and/or an honorably discharged veteran.

I certify that my student account is up to date and not in any type of financial hold status.

First Name

Middle Name

Last Name

Student ID Number

Saint Leo University Email Address

City

State

Mailing Zip/Postal Code

Home Phone Number

Mobile Phone Number

Marital Status

Number of Dependents

Are you receiving financial aid?

Have you completed a FAFSA®?

Number of hours currently enrolled

Choose your center location

Student Type

GPA

Are you currently on academic probation?

Monthly Income

Monthly Obligations

Employer

Position

Have you applied for other financial assistance?

Amount Requested (max $500)

Intended use for requested funds

Funds to be sent to the following location

Explanation for emergency fund request

By (digitally) signing the application below, I certify that:

The information is complete, true, and correct;
This funding is necessary to continue my education at Saint Leo University;
I will return any remaining monies not used back to the Veteran Student Emergency Fund as a good faith gesture;
I will complete a financial planning course of some sort before I will be permitted to apply to this fund again. I understand that I may receive assistance as long as funds are available.

I acknowledge that submitting an application does not guarantee funding.

I acknowledge that the Student Veteran Emergency Fund is entirely dependent upon donations.

Digital Signature