FAST Fund Application

FAST Fund is an emergency financial fund for current Western Wyoming students.

This form may be completed by a student or by a Western employee working on behalf of a student.

The form will be sent to the FAST fund team and we will be in touch as soon as possible.

Heidi Currutt, Distance Learning Outreach
Torie Bertagnolli, Wellbeing & Accessibility

Rich Ackerman, MIT Faculty

Julie Leavitt, Nursing Faculty
Stacie Lynch-Newberg, Developmental Studies Faculty

* Required

Student Western Email *

Student First Name: *

Student Last Name: *

Phone Number: *

Major: *

Credits this Semester: *

City *

State *

Western Employee Reference Name: *

Western Employee Reference Phone Number:

Western Employee Reference Email:

Please explain the student's need for FAST Fund assistance.
Be as detailed as you can with specific types of needs and dollar amounts. *

How would FAST Fund money help you continue on your path to graduation at Western? *

Are you interested in more information about any of the following? (Optional) *

Scholarships for students who have spent any time in Foster Care or State Custody

Scholarships for undocumented students

Local Food Bank Information

Jobs on Campus

Help with FAFSA or applying for Financial Aid at Western

I am a Veteran / served in the Military.

My spouse and/or parents served in the Military

Non-traditional students (over 25 years old)

Have you ever previously applied to the FAST Fund? *

Yes

No

If so, please enter previous award amount.

How many are in your household? (Adults Children, other dependents including pets).

How did you hear about Western FAST Fund? *