HB3063 Referral Form

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Early College Credit students that have matriculated to BMCC and meet the criteria of the grant may be eligible for additional financial assistance during the 2016-2017 academic year.  Requests will be considered on a case-by-case basis and until all funding has been expended.  

Gift cards and other forms of assistance are provided up to $100 per request and a maximum of $150 for the academic year.   

Below are a few examples of the types of financial support we may be able to assist with:

  • Food
  • Transportation (taxi vouchers or gas) 
  • Childcare (funding not placement)
  • Vehicle Repair
  • Utilities
  • Books and Supplies
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Student Information

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Student Information
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Information About Student

Please share information about this student that will support your reason for referral.

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Information About Student Please share information about this student that will support your reason for referral.
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What type of assistance is the student in need of?

Please indicate below the type or types of assistance you are requesting for this student.

 

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What type of assistance is the student in need of? Please indicate below the type or types of assistance you are requesting for this student.
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If you selected "Other" above - please explain what type of assistance is needed.
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