Nursing Student Emergency Fund Application

This application is for Avila University nursing students only.

The Research Foundation is committed to supporting nursing students on their journey to become nurses. The Nursing Student Emergency Fund has been created to assist students in crisis.

Eligibility

The Nursing Student Emergency Fund is available for traditional BSN and accelerated BSN students at Avila University. Applicants must be full-time students (enrolled in 12 or more credit hours) to apply. If approved, applicants are eligible to receive up to $350 each calendar year.

In order to be considered for support, students must be able to demonstrate and describe the emergency situation that caused them to need financial assistance. Tuition owed is not considered an emergency need.

Acceptable emergency situations include (but are not limited to):

Housing insecurity
Lack of transportation to class or clinical sites
Utility shut-off notices
Food insufficiency
Other emergency needs identified by student

Application Requirements

To apply, complete the online application below. Applications can be submitted at any time. The Research Foundation will update students on their application status 48-72 hours after it was submitted.

Please note all applications must be completed online. The system requires that you submit all information at the same time. You will not be able to start your application and come back to it at a later time. If you have questions about completing the application, please email info@theresearchfoundationkc.org or call 816-276-4218.

Applicant Information

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Primary Phone (Required)

Secondary Phone

Email (Required)

Confirm Email (Required)

Last Four Digits of Social Security Number (Required)

Education Information

Student Status (Required)

Are you a full-time student (enrolled in 12 or more credit hours)?

Expected Date of Graduation (Required)

MM/YYYY

Financial Information

Number of person(s) in household (Required)

Number should include applicant

Description of household member(s) including relationship and age

Not required if applicant lives alone

Source of Monthly Income

Please put $0 if the category does not apply to you.

Salary or wages from current employment (Required)

Salary or wages from spouse's, fiancé's, partner's, etc. current employment (Required)

Student loans (Required)

All other sources of income combined (Required)

Include child support, government assistance, etc.

Describe other sources of income

Monthly Financial Obligations

Please put $0 if the category does not apply to you.

Mortgage or rent payments (Required)

Auto payments (Required)

Childcare (Required)

Credit card payments (Required)

Utilities (Required)

Medical bills (Required)

All other payments combined (Required)

Please describe all other payments combined

Assistance Information

Amount of QuikTrip gift card requested

Amount of Price Chopper gift card requested

Amount of Aldi gift card requested

Amount of utility financial assistance requested

Amount of rent/mortgage financial assistance requested

Explain why emergency financial assistance is needed (Required)

If applicable, upload bills you are requesting assistance with (mortgage statement, utility bills, rental lease, etc.)

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I am willing to be interviewed about my experience with the Nursing Student Emergency Fund and submit a photo to be used in donor communications.

Your story and photo will be sent to donors of the fund. These stories help communicate the impact of assistance.

Yes
No
Maybe Later

Photo Upload

Please upload photos to be used in donor communications.

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I certify that the information on this application is true to the best of my knowledge.