{"id":5463,"date":"2026-01-02T18:44:29","date_gmt":"2026-01-02T18:44:29","guid":{"rendered":"https:\/\/www.gcc.mass.edu\/sfs\/?page_id=5463"},"modified":"2026-01-02T18:44:29","modified_gmt":"2026-01-02T18:44:29","slug":"emergency-loan","status":"publish","type":"page","link":"https:\/\/www.gcc.mass.edu\/sfs\/forms\/emergency-loan\/","title":{"rendered":"Emergency Loan 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 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gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_5_2'>\n                            \n                            <span id='input_5_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input readonly='readonly' type='text' name='input_2.3' id='input_5_2_3' value='' tabindex='1001'  aria-required='true'     \/>\n                                                    <label for='input_5_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input readonly='readonly' type='text' name='input_2.6' id='input_5_2_6' value='' tabindex='1003'  aria-required='true'     \/>\n                                                    <label for='input_5_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <input type=\"hidden\" id=\"gwro_hidden_capture_5_2_2\" name=\"gwro_hidden_capture_5_2_2\" value=\"\" class=\"gf-default-disabled\" \/><input type=\"hidden\" id=\"gwro_hidden_capture_5_2_3\" name=\"gwro_hidden_capture_5_2_3\" value=\"\" class=\"gf-default-disabled\" \/><input type=\"hidden\" id=\"gwro_hidden_capture_5_2_4\" name=\"gwro_hidden_capture_5_2_4\" value=\"\" class=\"gf-default-disabled\" \/><input type=\"hidden\" id=\"gwro_hidden_capture_5_2_6\" name=\"gwro_hidden_capture_5_2_6\" value=\"\" class=\"gf-default-disabled\" \/><input type=\"hidden\" id=\"gwro_hidden_capture_5_2_8\" name=\"gwro_hidden_capture_5_2_8\" value=\"\" class=\"gf-default-disabled\" \/><\/div><\/fieldset><div id=\"field_5_3\" class=\"gfield gfield--type-text 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_5_3'>Student ID #<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_3' id='input_5_3' type='text' value='' class='medium'   tabindex='1005'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_11\" 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' for='input_5_11'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input readonly='readonly' name='input_11' id='input_5_11' type='email' value='' class='medium' tabindex='1006'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_5_12\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_3col gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Term<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_12'>\n\t\t\t<div class='gchoice gchoice_5_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Fall 2024'  id='choice_5_12_0' onchange='gformToggleRadioOther( this )'  tabindex='1007'  \/>\n\t\t\t\t\t<label for='choice_5_12_0' id='label_5_12_0' class='gform-field-label gform-field-label--type-inline'>Fall 2024<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Spring 2025'  id='choice_5_12_1' onchange='gformToggleRadioOther( this )'  tabindex='1008'  \/>\n\t\t\t\t\t<label for='choice_5_12_1' id='label_5_12_1' class='gform-field-label gform-field-label--type-inline'>Spring 2025<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_13\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_3col gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you borrowed from the Emergency Financial Aid Loan Fund in the past?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_13'>\n\t\t\t<div class='gchoice gchoice_5_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_5_13_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_5_13\" tabindex='1009'  \/>\n\t\t\t\t\t<label for='choice_5_13_0' id='label_5_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_5_13_1' onchange='gformToggleRadioOther( this )'  tabindex='1010'  \/>\n\t\t\t\t\t<label for='choice_5_13_1' id='label_5_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_5_13'>Students who have received an Emergency Financial Aid Loan in the past and who have not paid it back as agreed are not eligible to borrow from the program again. <\/div><\/fieldset><fieldset id=\"field_5_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Loan Request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_14'><div class='gchoice gchoice_5_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='Art class'  id='choice_5_14_1' tabindex='1011'  aria-describedby=\"gfield_description_5_14\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_1' id='label_5_14_1' class='gform-field-label gform-field-label--type-inline'>Art class<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Bus pass ($75)'  id='choice_5_14_2' tabindex='1012'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_2' id='label_5_14_2' class='gform-field-label gform-field-label--type-inline'>Bus pass ($75)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.3' type='checkbox'  value='Vehicle-related transportation ($75)'  id='choice_5_14_3' tabindex='1013'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_3' id='label_5_14_3' class='gform-field-label gform-field-label--type-inline'>Vehicle-related transportation ($75)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.4' type='checkbox'  value='Dental\/medical co-payment ($35)'  id='choice_5_14_4' tabindex='1014'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_4' id='label_5_14_4' class='gform-field-label gform-field-label--type-inline'>Dental\/medical co-payment ($35)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.5' type='checkbox'  value='Meals ($50)'  id='choice_5_14_5' tabindex='1015'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_5' id='label_5_14_5' class='gform-field-label gform-field-label--type-inline'>Meals ($50)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.6' type='checkbox'  value='Other'  id='choice_5_14_6' tabindex='1016'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_6' id='label_5_14_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_5_14'>Please check all that apply.<\/div><\/fieldset><fieldset id=\"field_5_15\" class=\"gfield gfield--type-list gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >List<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Number<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Instructor<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Supply Costs<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_15_cell1 gform-grid-col' data-label='Course Number'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Number, Row 1' data-aria-label-template='Course Number, Row {0}' type='text' name='input_15[]' value='' tabindex='1017'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_15_cell2 gform-grid-col' data-label='Instructor'><input aria-invalid='false' aria-required=\"true\"  aria-label='Instructor, Row 1' data-aria-label-template='Instructor, Row {0}' type='text' name='input_15[]' value='' tabindex='1018'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_15_cell3 gform-grid-col' data-label='Supply Costs'><input aria-invalid='false' aria-required=\"true\"  aria-label='Supply Costs, Row 1' data-aria-label-template='Supply Costs, Row {0}' type='text' name='input_15[]' value='' tabindex='1019'  \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_5_16\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_16'>Please describe your need and amount of loan requested<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_16' id='input_5_16' class='textarea medium' tabindex='1020' aria-describedby=\"gfield_description_5_16\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_5_16'><strong>Maximum loan amount is $125<\/strong><\/div><\/div><fieldset id=\"field_5_5\" class=\"gfield gfield--type-tos gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required 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