Black Student Academic Fund - COVID-19 Crisis Request Form
Due to the outbreak of COVID19 and the cancelation of universities throughout the state we will be offering resources from our Black Student Academic Fund as long as funds are available. Disclaimer - the funds that we are able to send you may not be all that you need

Please provide your ".edu" email address


For more information please contact us at info@themtrep.org
Email *
Name (First and Last) *
Phone Number (Please include area code)
County (e.g. Gallatin, Park, Glacier) *
How would you like to receive funds?
Please fill in all ways you are able to receive funds
PayPal (Please type YOUR PayPal user name)
Venmo (Please type in YOUR Venmo user name)
Check (Please type your street address, zip code, City)
How do you identify? (All that apply.) *
University, College, or Institution Affiliation *
Please outline/list your needs or situation here and tell us how you fit into one or more of the most vulnerable groups listed above. *
Estimate how much aid you need *
Any additional specifications, comments, or questions? *
Thank you for taking the time to tell us about your needs! We will contact you as soon as possible.
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