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Home / Student Services / Emergency Assistance Request

Emergency Assistance Request

Room: C-Building, C-235
Phone: (718) 482-5135
laguardiacares@lagcc.cuny.edu

In-Person
Monday- Friday 9 a.m.- 5 p.m.

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Monday- Thursday 10 a.m.- 3 p.m.

Rhonda Mouton, EdD Program Director

Marie Elie, Assistant Coordinator

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Health Center
Wellness Center
Responsibilities, Policies and More
Student Help
Academic Help

Room : C-Building, C-107
Phone : (718) 482-5135
laguardiacare@lagcc.cuny.edu
Hours of Operation

Emergency Assistance Request

Thank you for applying for emergency assistance. Please be advised that in order to qualify for assistance, it is a requirement that you are currently enrolled. If you have any questions or concerns regarding your enrollment status, documents or information needed to complete your application, please email laguardiacares@lagcc.cuny.edu.

Name(Required)

First Last

Email(Required)

Phone(Required)

Enter 8 Digit EMP ID, Program Name, or ACE ID:

ID Look Up Tool

Address(Required)

Street Address Address Line 2 City State ZIP Code

This field is hidden when viewing the form

I am currently enrolled:(Required)

Fall Session I

Fall Session II

Spring Session I

Spring Session II

Adult and Continuing Education (ACE)

Certificate Program

Citizenship Status(Required)

Are you a F1 Visa Student?(Required)

Do you have a disability and need reason accommodations?(Required)

Do you have a checking account?(Required)

Household Demographics(Required)

Check all that applies

Live alone

Roommates

Parents

Homeless

Other

Household Demographics (Other)

This field is hidden when viewing the form

I plan to finish/graduate in: (semester / month and year)(Required)

Amount of aid requested:(Required)

Are you employed?(Required)

Student Enrolled Status:(Required)

Please check all that applies:(Required)

Foster Care Program

Veteran

Receive SNAP, Cash Assistance, Medicaid, or Fair Fares

Social Security Benefits

Unemployment

Other

None of the above

Emergency Request (Check all that apply)(Required)

Books

Childcare

Internet

Metro Card

Phone Bill

Rent Assistance

Tuition

Utilities

Technology (i.e. computer, iPad)

Add Personal Care (i.e. toiletries, winter coat, etc.)

Other

Other

Emergency Request Other

Personal Statement

Reason Details:(Required)

Please state the reason(s) you are seeking emergency financial aid. Provide specific details and attach documentation: (Max. 150 words)

Planning for the Future:(Required)

How will you take care of the issue(s) moving forward?

Please use this dropbox link to submit all requested documents
Please ensure all your documents are labeled with your full name before returning to submit your application.

This field is hidden when viewing the form

File Upload:

Please upload any supporting documentation you may have to support your claim. (eg: employment separation, rent bill…etc.)

Drop files here or

Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 2 MB, Max. files: 5.

Disclaimer and Signature

Typing my name below certifies that the information reported on this form is true and complete to the best of my knowledge. I also understand that if I purposely give false or misleading information, the request will be denied.

Signature(Required)

Date(Required)

Month

Day

Year

Email

This field is for validation purposes and should be left unchanged.

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To contact us, call (718) 482-7200
CUNY LaGuardia Community College
31-10 Thomson Avenue
Long Island City, NY 11101 USA
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