Emergency Assistance Request Form

MSOE Student Emergency Financial Assistance Program

MSOE understands that students may face financial distress due to extenuating or emergency circumstances. When financial distress impacts a student’s abilities to meet immediate and essential expenses or jeopardizes their ability to continue enrollment, MSOE seeks to support while helping students navigate circumstances.

This form is not intended for persistent financial strain, but rather isolated circumstances due to extenuating or emergency situations. Examples include but are not limited to; housing, utilities, food, medical expenses, transportation, required materials for courses, etc. Requests for ongoing tuition and fees, credit card debt, entertainment or non-essential utilities will not be covered.

Please note that funding is limited and we may be unable to honor every request. Funding that is awarded may not eliminate the student’s entire financial distress.

* = required field

Name *

First

Last

MSOE ID Number *

Phone Number *

###

####

Year in School *

Have you requested financial assistance through this process in the past? *

Yes

In the space below please explain your unexpected financial hardship due to extenuating or emergency circumstances. *

What steps have you already taken to resolve your financial difficulties? *

Have you been working with anyone on campus regarding the above listed situation? If so, please list their names below. *

What is your funding request amount and purpose? Please note not all funding requests can be approved and financial support provided may differ from your specific funding request. *

Please upload any supporting documentation for your request if you have any. (i.e. receipt of purchase, bill for unexpected cost, repair estimate, notice). *

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Milwaukee School of Engineering

Emergency Assistance Request Form

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