MIAT First Name*Last Name*Student ID or Last Four Digits of SSN*Student Email* I am requesting the MIAT CARES Act Emergency Grant because I have been financially impacted due to COVID-19 as the result of one or more of the following:*(check all that apply) Job loss or reduction of income (including reduced hours at work) for the household Temporary furlough (you or a member of your household have not lost your job, but your position has been temporarily put on hold) Medical (including additional support needed for accessibility purposes) Additional costs related to the transition to online learning I am requesting the grant to cover the following expenses:*(check all that apply) Housing Food Utilities Course Materials Childcare Technology or other resources needed for online coursework Medical expenses (including additional support needed for accessibility purposes) Are you receiving financial assistance from other sources to help with these expenses?*YesNo
