Student Funding Request Form

Please fill out the following form to start your request for funding from College Bound! While we cannot guarantee that we will cover your costs, we will do our best to support you in figuring out a solution to your concern.

Please be aware, it can take between 7 and 10 business days to fully explore and fulfill your request (if approved).

About You

Your First Name

Your Last Name

Your Email Address

Which program are you in?

Which year in high school are you?

Who is your coach?

If you are working with a therapist or case manager, select their name:

Funding Details

What kind of funding do you need?

If you need money for something besides school-related needs, select "Crisis Funding."

What kind of crisis funding?

Describe the Other crisis funding

When is this payment needed by?

Where does this need to be paid?

Provide the name of the company, institution, or vendor.

What is the total amount needed?

You can estimate if you need to, but try to be as accurate as you can!

Needs Assessment

Tell us about the circumstances that have led to you needing funding.

Tell us about the kind of computer or technology you need.

Tell us a bit about why you need financial help in this area.

Please provide the list of books/items and cost (include the Title, ISBN number, and price).

FOR STLCC students: Include your class code (EX. ENG 101) and campus!

Pressing SHIFT+ENTER will allow you to put each book on a separate line.

Which schools are you applying to and the fee for each?

Pressing SHIFT+ENTER will allow you to put each school on a separate line.

Where are you ordering transcripts from and where are you sending them to?

Pressing SHIFT+ENTER will allow you to put each item on a separate line.

Tell us about the exam or prep materials you need.

Pressing SHIFT+ENTER will allow you to put each item on a separate line.

Are you able to cover any portion of this on your own? If so, tell us about what you are able to contribute and by when.

If you have a bill, account statement, list of fees, or any other documents related to this request, please upload here:

Contact Information