Spiders Helping Spiders Application

General Information

I am a ___________________ student. *

First: *

Last: *

UR ID: *

UR Email: *

Cell Phone:

General Questions

Other - Please Explain: *

Have you accessed other applicable resources for this need? *

Yes

No

Have you filed a health insurance claim? *

Yes

No

Do you intend to stay on campus during the University closure? *

Yes

No

You must receive approval from Residence Life & Housing to remain on campus during University closures.

Approximate Amount Needed: *

The Spiders Helping Spiders Initiative is designed to support students with demonstrated financial need. By clicking this box below I affirm that I am receiving need-based financial aid from the University or have had a significant change in circumstances for which I need financial assistance. *

I affirm

Please briefly describe (<200 words) the support you are seeking and why you are in need of support. *

Do you have access to a computer? *

Yes

No

Please describe what computer/technology assistance you are seeking: *

Referrer Information

Who referred you to this funding program?

Referrer:
Please begin typing the name of your referrer (First and Last) and select from the list that appears.

My referrer is not listed.

Name of Person (First and Last) or Office who referred you to the program:

Signature

I certify that the attached statements are true and accurate. *

I certify

Signature: *

Today's Date: *

Confidentiality

The Family Educational Rights and Privacy Act (FERPA) protects the privacy of students’ educational records and personal information, including financial aid status. Considering the sensitivity of situations of financial hardship, all information shared by a student requesting emergency funding support is confidential. The University’s FERPA policy is available online.