Hardship Fund : Acknowledgement Form
Hardship Fund : Acknowledgement Form
A Beacon for Students
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Acknowledgement
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Payment Information
Student's Name
Student's Name
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First
Last
Student's Email
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Use of Funds
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Use of Funds
I agree that I will use funds provided by the Hardship Fund for the purposes indicated on my application and/or clarified through email communication to the Hardship Fund Committee.
Submission of Receipts
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Submission of Receipts
I am aware that I will be required to submit a receipt (or receipts) confirming my use of funds received through the Hardship Fund.
Taxable Income if receipts not submitted within 10 business days
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Taxable Income if receipts not submitted within 10 business days
I understand that if I do not submit a receipt within 10 business days of receiving funds from the Hardship Fund, the amount received will become taxable income.
By signing below I acknowledge that I agree to and understand the requirements outlined above:
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Draw
or
Type
By signing electronically below, I confirm that I am able to access information in an electronic form and I also agree that the institution does not need to provide me with an additional paper (non-electronic) copy of the document unless specifically requested.
Clear
Full Name
By signing electronically below, I confirm that I am able to access information in an electronic form and I also agree that the institution does not need to provide me with an additional paper (non-electronic) copy of the document unless specifically requested.
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