Apply for Assistance

Name

First Name

Last Name

Street Address

City

State

Zip Code

Phone

(###)

###

####

Preferred Method of Contact

Phone

College of the Holy Cross Affiliation

Year of Graduation for You or Spouse

Projected Household Income for 2025*

Household Income for 2024*

Estimated Total Value of Household Cash, Checking Accounts, and Savings Accounts*

Major Financial Obligations

Rent/Mortgage Payment

Monthly Debt Payments (e.g., loans, medical bills)

Is anyone else providing assistance with the expense? If so, how much in total?

Please provide any additional information that would assist CCF in understanding your financial situation.

Total Amount of the Expense

Description of the Expense

Name of Recipient and Their Relationship to the Applicant

Vendor(s)

Can CCF pay the vendor(s) directly? (We would prefer to do so)

Please provide any additional information that would assist CCF in understanding the expense and how it will impact the recipient.

May we share your story anonymously to help raise funds for this and other requests?

How did you hear about this grant?

College Alumni Office

Friend/Family

Social Media

Email Newsletter

Other

Please provide any additional information that would help CCF better understand your application

By submitting this application you acknowledge that CCF will hold this information as confidential, but may need limited additional information to verify requirements such as your graduation from the College of the Holy Cross. You also acknowledge that if the information provided is false, you may be denied a grant and/or be liable to repay CCF for any grants paid as a result of your application (including grants paid directly to vendors). You also attest that the information in this application is complete and accurate to the best of your knowledge and understand the process and your responsibilities.

Apply for Assistance

Crusaders Care Fund