Supporting Students Experiencing Homelessness (SSEH) Grant

Student Name(Required)

First Last

Preferred Name

First Last

Pronouns

ctcLink ID(Required)

Phone(Required)

Email(Required)

Program of Study(Required)

How did you hear about housing assistance funding at Grays Harbor College?(Required)

Are you currently enrolled as a student at GHC?(Required)

Yes

What is your current situation (Select all that apply)(Required)

Experiencing or at imminent risk of homelessness - Unsheltered

Experiencing or at imminent risk of homelessness - Sheltered (e.g., couch surfing or staying with family/friends)

Experiencing housing insecurity

Former foster youth during high school

None of the above

How likely are you to drop out or take a break from college at this point in time?(Required)

Likely

Not Likely

If you were to receive emergency grant funds, how likely are you to complete the current quarter?(Required)

Likely

Not Likely

If you were to receive emergency grant funds, how likely are you to enroll in this college next quarter?(Required)

Likely

Not Likely

Use of Resources

Are you participating in or receiving any resources from any of these programs/services? (Select all that apply)(Required)

Have you utilized any of the following campus resources? (Select all that apply)(Required)

Harbor Landing Food Pantry

Snack Cabinets

Childcare Assistance

Other

None of the Above

Are you utilizing any of the following community resources? (Select all that apply)(Required)

Extended Foster

Food Pantry/Local Food Bank

Coordinated Entry

Housing Authority

CCAP

Other

None of the Above

Which college or community resources would you like information on? (Select all that apply)(Required)

Other resources I would like information on:(Required)

Type of Funding Requested

If you need assistance with housing funding, select the one housing category that best fits your needs:

Eviction Prevention (meant to help keep students in their current housing by preventing an eviction)

New Rental Assistance (meant to help students pay the extra rent and security deposit required for a new rental)

Emergency Housing (meant to help students who need emergency, short-term housing)

Please describe the emergent situation that is the cause of your need for assistance.(Required)

How does this emergent situation impact your ability to complete this quarter of college? Do you foresee any factors other than this emergency that may impact your ability to complete this quarter of college?(Required)

What is the address you are being evicted from?(Required)

Street Address Address Line 2 City State ZIP Code

Do you own or rent this location?(Required)

What is the amount you owe to prevent eviction?(Required)

If you are awarded funding through the SSEH Program, how will be able to continue to pay for your housing moving forward?*(Required)

Responses such as ‘I will look for a job’ are not sufficient. Please provide as much detail as possible. *Funding is awarded on the ability to be able to pay your rent moving forward as SSEH is a one-time funding program.

Upload Documentation(Required)

Please attach official paperwork outlining the eviction or potential eviction from the property manager or landlord. This should show the amount you are behind that will cause an eviction, show that the student is on the lease, state the address of the property, list the contact information of the property manager or landlord, and be signed by the property manager or landlord. A typical form of documentation would be a “14 Day Pay or Vacate Notice” but other forms of communication from your landlord or property manager may be acceptable if they have the required details. Text messages are not sufficient.

Drop files here or

Max. file size: 64 MB.

What is the address of your new rental?(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is the amount you are requesting to moving into your new rental?(Required)

How does this situation impact your ability to complete this quarter of college? Do you foresee any factors other than this situation that may impact your ability to complete this quarter of college?(Required)

If you are awarded funding through the SSEH Program, how will be able to continue to pay for your housing moving forward?*(Required)

Upload Documentation(Required)

Please attach the new rental agreement or letter of intent from the property manager or landlord. This should show the first and last month’s rent and deposit needed for the new rental. It should include the property address and contact information for the rental agency or landlord and should indicate that you, the GHC student, will be on the lease. Only Rent and Security Deposit are eligible for potential funding. Rental applications are not sufficient documentation of a new rental.

Drop files here or

Max. file size: 64 MB.

Please describe the emergent situation that is the cause of your need for assistance.(Required)

What is the name and location of the emergency housing you will be using? If you need help locating emergency housing, please contact our Resource Navigator at 360-538-4058.(Required)

What is the amount you are requesting for your emergency housing needs?(Required)

Upload Documentation(Required)

Please attach documentation of the rental location plus weekly and/or monthly rates, as well as how long you will be needing emergency housing until you are in a new reliable housing. Emergency housing is for a maximum of 30 days. If you are having difficulty with this, please contact our Resource Navigator at 360-538-4058.

Drop files here or

Max. file size: 64 MB.

If you need assistance with storage funding, select the secure storage option below:

Secure Storage (to help with costs associated with storing possessions due to housing insecurity)

What is the name and location of the secure storage facility you are using?(Required)

What is the amount you are requesting for your secure storage unit?(Required)

Upload Documentation(Required)

Please attach documentation from the storage facility of your storage charges owed. This should include the name and address of the facility, the amount owed, and include your name (the GHC student) as the renter of the storage unit.

Drop files here or

Max. file size: 64 MB.

If you need assistance with funding for laundry and/or hygiene products, select the appropriate options below:

Laundry Assistance (to help with costs of doing laundry due to housing insecurity)

Hygiene Assistance (to help with costs of maintaining hygiene due to housing insecurity)

What is the amount you are requesting for laundry facilities and/or products?(Required)

What is the amount you are requesting for hygiene facilities and/or products?(Required)

Signature(Required)

By signing this document, I commit to using the Supporting Students Experiencing Homelessness Grant for its intended purposes, outlined in this application. I also agree to allow college staff to contact me to follow up on my progress after the application is submitted. I verify that all information provided in this application is true and verifiable.