BW Student Resource Center

The Student Resource Center supports BW students facing barriers that impact their educational success. We serve to connect students to local resources and campus services.

After completing this form you will be contacted by a member of the Brain Center / Student Resource Center to set up a virtual meeting to discuss your situation and connect to available resources.

Learn more about the Student Resource Center at our BW page.

Student Resource Programs Include:

- Swipe Out Hunger Program

- Student Emergency Grant Program

- Campus Cupboard

- Connection to general campus and community resources

Student Resource Center Contact information: studentresource@bw.edu or x3174

Applicant Information

I am applying for: *

Student Emergency Grant Program

Intake Meeting Request (Get information on meal programs, housing insecurity, childcare...)

Campus Cupboard Survival Kit (meal/essentials kit)

Campus Cupboard Visit

Is this your first time applying for resources through the Student Resource Center this academic year? *

Yes

No

Today's Date * +

First name *

Last name *

Date of Birth * +

Email Address *

Phone Number *

Student ID *

Current Class Standing *

Expected date of graduation (term & year) *

Current Address (street, city, state, zip) *

Did a faculty/staff member refer to you to this resource? If yes, who?

Gender identity *

Race / Ethnicity *

Are you a veteran? *

Yes

No

Marital Status *

Employement Status *

Current Living Situation *

Do you identify as a first generation college student (first in your family to complete a college degree)? *

Yes

No

I understand that in order to provide the most relevant resources to me the Student Resource Center will consult with the BW Office of Financial Aid. *

Yes

Swipe Out Hunger Application

THE SWIPE OUT HUNGER REQUEST FORM HAS MOVED! YOU DO NOT NEED TO SUBMIT THIS FORM IF YOU ARE ONLY REQUESTING MEALS THROUGH SWIPE OUT HUNGER!

PLEASE USE THIS LINK TO REQUEST MEALS THROUGH SWIPE OUT HUNGER:

https://bwcentral.etrieve.cloud/#/form/112

THE SWIPE OUT HUNGER REQUEST FORM HAS MOVED! YOU DO NOT NEED TO SUBMIT THIS FORM IF YOU ARE ONLY REQUESTING MEALS THROUGH SWIPE OUT HUNGER!

PLEASE USE THIS LINK TO REQUEST MEALS THROUGH SWIPE OUT HUNGER:

https://bwcentral.etrieve.cloud/#/form/112

Intake Meeting Request

By filling out an Intake Meeting Request, you will be contacted via email by the Student Resource Center Coordinator to schedule/confirm a day and time to meet. In the meeting, you will learn about all the resources and services available to BW students through the Student Resource Center and have time to discuss what particular resources you need. If necessary, the SRC Coordinator will walk you through filling out any additional forms for resources you may need (Emergency Grant, Swipe Out Hunger, Survival Kit, etc.).

Please check the day(s) you are available for a meeting: *

Best time of day to attend a meeting: *

Morning (8am-11am)

Early Afternoon (11am-2pm)

Late Afternoon (2pm-4pm)

Resources I would like additional information about: *

Student Emergency Grant Fund Application

This emergency grant fund is intended to support students facing short-term, emergency financial hardships that may present a barrier to persisting in your academic program.

Funding is based on available funds for the program. Generally, students are only eligible to receive 1 emergency grant per academic semester. For long-term financial planning for your education please consult with the Office of Financial Aid to determine possible resources. https://www.bw.edu/financial-aid/ or connect with the Student Resource Center to determine possible community/social service resources.

Please note: In order to serve the greatest number of students with the most immediate need related to the coronavirus (COVID-19) crisis the typical allocation will be $200 or less per student. Future grant requests should consider short-term immediate needs. Requests can be made for a greater amount but may not be able to be fully funded. Thank you for your understanding and concern for every student at BW.

STUDENTS MUST HAVE FILED THEIR FINANCIAL AID FORMS (FAFSA) IN ORDER TO QUALIFY FOR EMERGENCY GRANT FUNDING. AN EXCEPTION WILL BE MADE FOR INTERNATIONAL STUDENTS.

Items NOT funded by this emergency grant include tuition/fees, student loans, legal fines, credit card debt, previous/outstanding medical bills, auto insurance, cell phone bills, parking tickets, health insurance, study abroad costs, travel for academic conference/interviews, non-emergency travel expenses, or items on university bill.

Have you applied for a BW Student Emergency grant before? *

No

Yes, but I was not funded

Yes, and I was funded (please share what semester / year) Yes, and I was funded (please share what semester / year)

Have you completed your FAFSA for the current academic year? *

No

Yes Yes

What are you requesting emergency funding for? *

Childcare

Emergency Food / Grocery needs

Housing

Textbooks

Transportation / Travel

Technology needs (computer, wifi for remote instruction)

Utilities

Other: Please specify (please note items not funded in description above) Other: Please specify (please note items not funded in description above)

Please describe your current living situation (on-own, with family/parents, with roommates..etc) *

Emergency Grant amount requested ($) - please be as specific as possible. Typical grant allocation is $200 or less. *

Date funds are needed by * +

Please explain what this emergency financial support will be used for. If you are requesting funds for more than 1 thing a breakdown of specific expenses should be provided. A space is provided below for you to upload additional documentation (bills, receipts..etc). *

Upload available relevant documentation related to this emergency financial hardship (Bills, estimates, receipts...)

Please share what factors contributed to this becoming an emergency. *

Please share how you are currently addressing your financial need and what sources you have utilized. *

Please share what you plan to do if you do not receive an emergency grant. *

Student Agreement *

By signing signing this form, I certify that the above information is complete and accurate and I agree to provide bills and/or other documents requested in support of this application. In addition, I understand that submission of this application does not guarantee that additional assistance will be awarded.

Information / Data Privacy *

I understand that by submitting this application I am agreeing to have the content of this application and any future communications associated with this grant application shared with the staff members on the Emergency Grant Advisory Committee. This information will be shared for purposes of application review and funding determination.

Student Signature *

clear

Campus Cupboard Survival Kit

Campus Cupboard Survival Kits are kits curated for students to have supplemental food during breaks in the semester (Fall, Winter, Spring, and Summer). Survival Kits are only available during school breaks, but students can visit the Campus Cupboard any time while classes are in session. Students will be contacted via email when their survival kit is ready for pick-up in the Student Resource Center (second floor of the Union).

Will you have access to additional food during Fall Break? (answer will not determine eligibility) *

Yes

No

Will you have access to additional food during Winter Break? (answer will not determine eligibility) *

Yes

No

I need a survival kit for: *

In the survival kits, I am specifically in need of: *

Shelf-stable/Non-perishable food items

Perishable food items (refrigerated, not a long shelf life)

Cleaning supplies

Toiletries

Office/School supplies

Will you be staying on campus during Fall Break? *

Yes

No

Will you be staying on campus during Thanksgiving Break? *

Yes

No

Will you be staying on campus during Winter Break? *

Yes

No

Will you be staying on campus during Spring Break? *

Yes

No

Will you be staying on campus during Summer Break? *

Yes

No

Will you have access to additional food during Thanksgiving Break? (answer will not determine eligibility) *

Yes

No

Will you have access to additional food during Winter Break? (answer will not determine eligibility) *

Yes

No

Will you have access to additional food during Spring Break? (answer will not determine eligibility) *

Yes

No

Will you have access to additional food during Summer Break? (answer will not determine eligibility) *

Yes

No

Please list any food allergies or dietary restrictions.