Grant Opportunities - Clark State College Scholarships

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Adjusted gross income for entire household for the last tax year? Please enter a number. You can use a decimal, but exclude any other symbols.

First Name

Last Name

Have you completed the FAFSA?

Yes

No

Information from your applicant record (located in the bottom left of screen) will be used to match you to specific scholarship opportunities. Please review and confirm that the information in your applicant record is accurate.

Yes, the information in my applicant record is correct.

No, but I have contacted the Registrar's Office at 937-328-6015 with changes.

Cumulative GPA Please enter a number. You can use a decimal, but exclude any other symbols.

Applicant Last Name:

Applicant Middle Intitial:

Date of Birth:

County of Residence:

Program of Study at Clark State:

Clark State email address:

State

Marital Status

Single

Married

How did you hear about Clark State Scholarships?

Adviser

Coach

Email

Faculty

Financial Aid Office

Student Portal

Other

Other Information to be Considered

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Are you a veteran or active duty military member (Not Dependent Status)?

No

Veteran

Active Duty

Are you a first generation college student? (Neither parent has completed a Bachelor degree or higher)

Yes

No

Were you a foster child on your 18th birthday?

Yes

No

Current Employment Status

Unemployed

Employed Part-Time (30 hours or less)

Employed Full-Time (30 hours or more)

Do you currently receive SNAP benefits through Ohio Job and Family Services?

Yes

No

Anticipated Graduation from Clark State, month/year

Are you currently receiving or eligible to receive a Pell Grant?

Yes

No

Degree or program of study

Have you applied for Emergency Funds in the past?

Yes

No

Are you eligible to receive or currently receiving a Pell Grant?

Yes

No

Have you completed the Free Application for Federal Student Aid (FAFSA) for this academic year?

Yes

No

Agree to Terms: I understand the requirements of the Emergency Fund Program, including *ELIGIBLE EXPENSES MAY INCLUDE:* Child Care, Food/Meals, Gas, Housing/Rent, Medical/Dental Expenses, Personal Automobile Expenses, Public Transportation/Bus Pass, Tuition, Fees, Books, Course Related Supplies and Utilities *NON-ELIGIBLE EXPENSES INCLUDE:* Alcohol, Entertainment Expenses, Legal Fees, Tobacco. *CURRENT STUDENT PROGRAM ELIGIBILITY REQUIREMENTS:* Maximum award not to exceed $500 for students who meet the following criteria: Must have a 2.0 GPA or higher. Be currently enrolled in 6 or more credit hours. Have completed one term at Clark State Community College. Have not received an award within the current semester. Have not received 3 awards (3 award limit).

Yes

No

In order to be approved for this grant opportunity, students are REQUIRED to have a FAFSA (Free Application for Federal Student Aid) on file and be compliant with all federal aid requirements. Federal aid requirements for student aid include, but are not limited to, meeting financial aid satisfactory academic progress, not have a loan in default or a grant overpayment, be a US citizen or eligible non-citizen with current documentation. Do you have a 2019-2020 FAFSA on file?

Yes

No

Have you been financially impacted by COVID-19? If so, please describe how you have been financially impacted and why you are requesting this support.

Enrollment status for current semester

Less than 6 credit hours

6-11 credit hours

12 or more credit hours

What is the Expected Family Contribution (EFC) found on your FAFSA Student Aid Report?

Clark State Email Address

Are you a veteran or active duty military member (not dependent status)?

No

Veteran

Active Duty Military

Marital Status

Married

Single

Were you unsuccessful in Spring 2020 semester due to issues related to the COVID-19 pandemic? If so, please provide a detailed explanation of your situation and the circumstances related to your academic difficulties.

Alternate Email Address

Total annual family income

Total number of years you have attended Clark State. Please enter a whole number, no decimals or other symbols.

Indicate the assistance you require at this time. Check all that apply. To select multiple items, hold control or command and click each one.

Food Assistance

Housing/Rent

Healthcare

Childcare

Gas

Personal Automobile Expenses

Public Transportation/Bus Passes

Utilities

Tuition/Course Materials

Technology

Other Critical Need

Do you have any technology needs? If yes, please explain.

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Are you registered with the Clark State Office of Accessibility?

Yes

No

Academic Program To select multiple items, hold control or command and click each one.

How did you hear about Clark State's CRRSA Fund? If faculty or staff, please include name.

By submitting this application, I am verifying that I have exceptional need that is the result of the coronavirus pandemic and that these funds will be utilized to cover expenditures associated with my cost of attendance at Clark State College or for emergency costs that arise due to the coronavirus, such as food, housing, health care (including mental health care) or child care.

Yes

No