University of Houston
Dean of Students Office
713-743-5470 phone, 713-743-5477 fax
EMERGENCY LOAN REQUEST
Name: __________________________ PeopleSoft ID: __________________
Amount Requested (maximum $300)
_______________
Have you been awarded Financial Aid?
Yes
No
LOANS MUST BE PAID IN FULL WITHIN THE DUE PERIOD OR LAST DAY OF
CLASS FOR THE SEMESTER REQUESTING LOAN (Whichever is first.)
Due period: 30 day in Summer semester & 45 days in Fall or Spring semester.
1. Please explain your unforeseen emergency. Be as explicit as possible and attach any
supporting documentation:
2. How will this loan money be used?
I certify that the facts set forth in this request for an emergency loan are true and complete
to the best of my knowledge.
Signature:___________________________________
Date:____________________
For Office Use Only:
Approved:
Yes
No
Amount:
Date:
Signature:
University of Houston
Dean of Students Office
Emergency Loan
Emergency loan approved by the Dean of Students Office will not be available for the
purchase of books, tuition, and room and board.
Criteria for Eligibility:
1.
Currently enrolled in at least 6 hours.
2.
Have no past due short-term loans or a history of past due short-term loans.
3.
Have no outstanding returned checks or a history of returned checks.
4.
Have no financial stops (you can check by going to Enrollment Services online)
5.
Have no delinquent university debts.
What to bring to the interview?
1.
Fee bill (needed only first week of each semester)
2.
Two forms of photo I.D.
3.
Documentation associated with the emergency.
Documentation needed to verify emergency:
Living Expenses: bills and/or past due notification
Car Payment, insurance, repairs: payment books, statements, estimates or name and
telephone number of party rendering services
Medical and Dental: name and telephone number of practitioner, appointment and/or bill