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PLEASE NOTE THAT ALL EMAIL CORRESPONDENCE MUST USE YOUR OFFICIAL SUNY NEW PALTZ ACCOUNT

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Student ID Number
Phone Number ### - ### - ####
Check All That Apply
Essential academic needs (Books or Supplies) Replacement of personal items due to fire, theft, flood, etc Emergency expenses related to dependents (e.g. childcare) Temporary transportation Security short-term housing Utilities or other basic needs
Describe your situation – what unforeseeable circumstance is creating this need?
Explain how these unexpected expenses might affect your ability to succeed as a student at SUNY New Paltz:
Funds cannot be issued directly to students – they must be paid directly to a vendor/provider.
(Due to the pandemic this requirement is temporarily waived)

What specifically do you need the funds for and to whom should it be paid?
Student Crisis Funds are limited. Have you requested support from any other sources (e.g. family, friends, financial aid, community resources, etc)?

If so, what efforts did you make and what were the outcomes of the request(s)? If not, describe why you have not sought financial assistance other than this emergency fund.
If you have any supporting documentation (copies of an invoice/bill/charge, bank statements, photos of damage, etc.) please attach them. If you are using a picture taken on a cell phone, please set the image size to “small” before uploading. 25MB maximum total size. Attachments may require time to upload, so please be patient after submitting.
By completing this application, I provide the Crisis Fund administrators permission to communicate on my behalf with the vendors who potentially would receive support from this fund.
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