Le Moyne HOPES Emergency Funding Application

The HOPES Emergency Fund is committed to supporting students as they navigate unexpected challenges that may impact their academic progress and overall well-being. Grounded in a whole person approach, funding is intended to help stabilize essential needs such as housing, food, transportation and safety.

Students whose circumstances extend beyond an initial award are encouraged to reapply or to connect directly with the HOPES team to discuss their situation. We recognize that financial hardships are often complex and evolving, and we are here to partner with you in identifying appropriate supports.

All applications are reviewed by a confidential team of Le Moyne College professionals committed to a fair, thoughtful, and student-centered process. Information shared in your application will be treated with care and will only be accessible to the review team. Careful consideration is given to ensuring the equitable and sustainable use of limited funding resources

Our goal is to ensure that students feel supported, respected, and empowered as they continue their journey in healthcare training.

Please note: Scholarship awards or emergency funding may be considered taxable income under federal and state guidelines. Because individual circumstances vary, we recommend consulting a tax professional for personalized guidance.

First Name

Last Name

Birthdate

Email (@lemoyne.edu)

Phone Number (Mobile)

Student ID Number

Which of the programs below are you enrolled in?

M.S. Clinical Mental Health Counseling

M.S. Family Nurse Practitioner

M.S. Occupational Therapy

M.S. Physician Assistant Studies

Are you currently working for pay?

Please describe the type of need for which you are requesting support.

This is a guide for your reference. You are not expected to share more than you are comfortable with—only what feels necessary to explain your request.

Emergency Needs
Immediate, unexpected situations that require urgent support to prevent significant harm or interruption to your ability to continue your studies. Examples may include (but are not limited to):

Eviction or housing insecurity
Urgent or unplanned medical procedures
Utilities at risk of shutoff

Emergent Needs
Unanticipated challenges that are not immediately life-threatening but, if left unaddressed, could quickly escalate and impact your academic progress or well-being. Examples may include (but are not limited to):

Car repair following an accident or sudden breakdown
Short-term food insecurity
Replacement of broken or lost essential supplies

General Needs
Predictable or ongoing expenses that are typically anticipated as part of graduate education but may still create temporary financial strain. Examples may include (but are not limited to):

Required textbooks or educational materials
Regular transportation costs or car payments
Monthly utility expenses

Select your type of need below:

Please select the relevant needs you are seeking support for (check all that apply):

Please provide an estimate of the expenses you plan to use this emergency funding for:

For example:
$300 for unanticipated medical expenses related to higher co-pay for prescriptions
$220 for unanticipated transportation expenses, flat tire while on clinical rotations

Please use the responses below to share why this support is needed at this time, along with any relevant background or context that will help us understand your situation. Share only what feels necessary to help us understand your situation.

What expense or need are you requesting support for?

Please explain:

Why is this support needed at this time? Please briefly describe the circumstances or situation that led to this expense.

What is the total dollar amount you are requesting?

Optional: Is there anything else you would like the committee to know as they consider your application This may include context not captured above or information you believe would be helpful in understanding your request?

This form is not a guarantee of funding or acceptance to the HOPES Program at Le Moyne College. Upon submission, your application above will be reviewed by our team. If you meet the initial criteria, you will be invited to meet with our staff to discuss your candidacy and the grant commitments in more detail.

Please note that this funding is made possible by a New York State grant. Reporting procedures may change in the future, and we ask that any recipient of emergency funding keep careful financial records in the event that further documentation is required. This involves saving invoices and receipts for goods/services purchased with the emergency funds.

Please acknowledge:

By accepting this funding, you agree to the release of any necessary demographic and academic related information to the HOPES team and New York State.

Please acknowledge:

I verify that I am a currently registered graduate student at Le Moyne and that all the information in this form is truthful. I have read the important information at the top of this form.