{"id":723,"date":"2022-10-06T14:19:53","date_gmt":"2022-10-06T19:19:53","guid":{"rendered":"https:\/\/www.bemidjistate.edu\/offices\/student-life-success\/?page_id=723"},"modified":"2022-10-14T08:41:42","modified_gmt":"2022-10-14T13:41:42","slug":"supplemental-support-under-the-american-resource-plan-funding-application","status":"publish","type":"page","link":"https:\/\/www.bemidjistate.edu\/offices\/student-life-success\/crisis-resources\/supplemental-support-under-the-american-resource-plan-funding-application\/","title":{"rendered":"Supplemental Support Under the American Resource Plan Funding Application"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_11' style='display:none'><div id='gf_11' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Application for SSARP Funding<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/offices\/student-life-success\/wp-json\/wp\/v2\/pages\/723#gf_11' data-formid='11' novalidate>\n        <div id='gf_progressbar_wrapper_11' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_11_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_11_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_11_1'>\n                            \n                            <span id='input_11_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_11_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_11_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_11_4\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_4'>Please enter your primary phone number (including area code)<\/div><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_11_4' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_11_4\"  \/><\/div><\/li><li id=\"field_11_15\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_11_15_container'>\n                                <span id='input_11_15_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_15' id='input_11_15' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_11_15' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_11_15_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_15_2' id='input_11_15_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_11_15_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_11_2\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_2'>What is your NTC ID number?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_2'>This can be found on your student ID or in e-Services<\/div><div class='ginput_container ginput_container_text'><input name='input_2' id='input_11_2' type='text' value='' class='medium'  aria-describedby=\"gfield_description_11_2\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_3\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_3'>Please select your primary or home institution.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_3'>Funds are only available for Northwest Technical College students.<\/div><div class='ginput_container ginput_container_select'><select name='input_3' id='input_11_3' class='medium gfield_select'  aria-describedby=\"gfield_description_11_3\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Northwest Technical College' >Northwest Technical College<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_11_6' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_2' class='gform_page' data-js='page-field-id-6' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_11_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_11_5\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_5'>Please provide a brief description of how the COVID-19 pandemic has impacted you financially related to your education.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_11_5' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >For what purpose(s) will the CRRSSA Funding be used? Select all that apply.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_8'><li class='gchoice gchoice_11_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='Child Care Expenses'  id='choice_11_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_1' id='label_11_8_1' class='gform-field-label gform-field-label--type-inline'>Child Care Expenses<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.2' type='checkbox'  value='Course Materials'  id='choice_11_8_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_2' id='label_11_8_2' class='gform-field-label gform-field-label--type-inline'>Course Materials<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.3' type='checkbox'  value='Food\/Groceries'  id='choice_11_8_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_3' id='label_11_8_3' class='gform-field-label gform-field-label--type-inline'>Food\/Groceries<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.4' type='checkbox'  value='Health Care Expenses'  id='choice_11_8_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_4' id='label_11_8_4' class='gform-field-label gform-field-label--type-inline'>Health Care Expenses<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.5' type='checkbox'  value='Housing Expenses (rent or mortgage)'  id='choice_11_8_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_5' id='label_11_8_5' class='gform-field-label gform-field-label--type-inline'>Housing Expenses (rent or mortgage)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.6' type='checkbox'  value='Technology'  id='choice_11_8_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_6' id='label_11_8_6' class='gform-field-label gform-field-label--type-inline'>Technology<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.7' type='checkbox'  value='Transportation (auto repairs, auto payments, etc.)'  id='choice_11_8_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_7' id='label_11_8_7' class='gform-field-label gform-field-label--type-inline'>Transportation (auto repairs, auto payments, etc.)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.8' type='checkbox'  value='Utilities'  id='choice_11_8_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_8' id='label_11_8_8' class='gform-field-label gform-field-label--type-inline'>Utilities<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_8_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.9' type='checkbox'  value='Other'  id='choice_11_8_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_8_9' id='label_11_8_9' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_19\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_19'>If other...<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_11_19' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_9\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_9'>What amount of SSARP funds are you requesting for this one-time grant? (Please note there is a $500 limit per student).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_9' id='input_11_9' type='text' step='any'  max='500' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_11_9\" \/><div class='gfield_description instruction ' id='gfield_instruction_11_9'>Please enter a number less than or equal to <strong>500<\/strong>.<\/div><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_12' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_12' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_3' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_11_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_11_11\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_11'>VERIFICATION (Optional): Please upload verification of the expense. Documentation may include: A bill, lease, or other related documentation, etc.<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='16384000' \/><input name='input_11' id='input_11_11' type='file' class='medium' aria-describedby=\"gfield_upload_rules_11_11\" onchange='javascript:gformValidateFileSize( this, 16384000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_11_11'>Max. file size: 16 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_11_11'><\/div> <\/div><\/li><li id=\"field_11_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you have a Free Application for Federal Student Aid (FAFSA) for the 2022-2023 academic year currently on file with the Financial Aid Office at BSU or NTC?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_11_17'>\n\t\t\t<li class='gchoice gchoice_11_17_0'>\n\t\t\t\t<input name='input_17' type='radio' value='Yes'  id='choice_11_17_0'    \/>\n\t\t\t\t<label for='choice_11_17_0' id='label_11_17_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_11_17_1'>\n\t\t\t\t<input name='input_17' type='radio' value='No'  id='choice_11_17_1'    \/>\n\t\t\t\t<label for='choice_11_17_1' id='label_11_17_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >If you answered \u201cno\u201d to having a FAFSA on file with the Financial Aid Office, do you certify under the penalty of perjury that you are eligible to participate in the Title IV programs under Section 484 in Title IV of the Higher Education Act of 1965, as amended (HEA) [20 USC 1091(a)]?.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_11_18'>\n\t\t\t<li class='gchoice gchoice_11_18_0'>\n\t\t\t\t<input name='input_18' type='radio' value='Yes'  id='choice_11_18_0'    \/>\n\t\t\t\t<label for='choice_11_18_0' id='label_11_18_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_11_18_1'>\n\t\t\t\t<input name='input_18' type='radio' value='No'  id='choice_11_18_1'    \/>\n\t\t\t\t<label for='choice_11_18_1' id='label_11_18_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Furthermore, you certify that all of information provided in this application is true and complete to the best of your knowledge.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_11_13'>\n\t\t\t<li class='gchoice gchoice_11_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='Yes'  id='choice_11_13_0'    \/>\n\t\t\t\t<label for='choice_11_13_0' id='label_11_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_11_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='No'  id='choice_11_13_1'    \/>\n\t\t\t\t<label for='choice_11_13_1' id='label_11_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Send me an email receipt of my responses. 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