DreamKeeper Application
Eligibility Information
Are you enrolled in an eligible curriculum program at Central Carolina Community College OR have you been formerly enrolled in a curriculum program at Central Carolina Community College and are currently seeking re-enrollment at Central Carolina Community College?
Do you have a documented, time limited, specific academic expense, event, or emergency situation that has caused a financial hardship OR a small balance with the Central Carolina Community College Business Office that prevents you from completing registration?
Contact Information
First Name:
Your answer
Last Name:
Your answer
Date of birth:
Your answer
Student ID #:
Your answer
Address:
Your answer
City:
Your answer
State:
Your answer
Zip Code:
Your answer
Telephone Number:
Your answer
Email:
Your answer
Explanation of Need
Provide a detailed explanation of the expense/event(s) for which you are in need of assistance in the space provided below:
Your answer
How much funding are you requesting? How will this funding be used?
Your answer
If you are receiving aid, have you received a refund check? Please provide a breakdown of how funds were used.
Your answer
Please provide the name of a Central Carolina Community College staff or faculty member that will provide your recommendation for assistance:
Your answer
Note: Statement of Need
If you are approved, you will be required to provide documentation of expense or tuition balance.
I affirm that all information on this application is complete, true, and correct and that I am in need of these funds in order to continue my education at Central Carolina Community College.
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