Housing Insecurity Emergency Request 
Homelessness or housing insecurity is defined as individuals who lack a fixed, regular, and and adequate nighttime residence.  In order to qualify for the Housing Insecurity Emergency Assistance grant, a student must meet one or more of the qualifiers:  (1) Temporarily staying with other people (couch-surfing/doubled-up); (2) Staying in emergency shelter or transitional shelters; (3) Staying in motels, campgrounds, cars, parks, abandoned buildings, bus/train stations, or any public or private place not designed for humans to live in; (4) Staying in substandard housing; (5) Residing in a unsafe community area; (6) Has moved frequently because of economic reasons; (7) Is living in the home of another due to economic hardship; (8) Has been notified that your right to occupy their current housing or living situation will be terminated; (9) Lives in overcrowded housing; (10) Is exiting an institution; (11) living with an abusive partner or family member

Emergency Assistance is intended to assist students who face unexpected costs that impede their ability to continue and succeed academically and personally while enrolled at Chicago State University.  If you are experiencing difficulty paying for time-sensitive expenses, including housing/rent, food, transportation, utilities, medical care, childcare, books, school fees, or other basic necessities, please fill out the following form, and include a brief summary of of your circumstance.  Currently enrolled students may be eligible for some form of assistance.

If you are submitting this form during normal business hours and would prefer to talk to someone in-person, please contact the Counseling Center located in the Cordell Reed Student Union, Suite 190, no appointment is necessary.

Upon submission of this form, a professional staff member from the Counseling Center will be in contact within 24-48 hours (excluding weekend days) to discuss the best ways to support you.  The counseling team member who respond to these requests are dedicated to supporting students in times of immediate need.  Your information will be kept confidential within this small group of team members.  
Email *
First and Last Name *
Address *
Student ID Number *
Age *
Gender *
Race/Ethnicity *
Email Address *
Phone number *
Student Status *
Are you a U.S. Citizen (required for application) *
Are you an Illinois resident (required for application) *
Expected Date of Graduation *
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Current GPA *
Homelessness or housing insecurity is defined as individuals who lack a fixed, regular, and and adequate nighttime residence.  This specifically includes individuals whose living situations fall into one of the following categories.  In order to qualify for emergency assistance, a student must meet one or more of the qualifiers.  Please indicate all that apply.  *
At Risk for Homelessness  *
Check all that applies *
Required
Your Circumstance (Describe your financial hardship) and include the amount of assistance you are seeking  *
A copy of your responses will be emailed to .
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