Spring 2024- Text Book Scholarship Request Form

Summer 2025 - Textbook Assistance Request Form

Please complete the following form to request financial assistance for textbooks and course materials.
Name*

First NameLast Name
Student ID Number:*
Phone Number*
Please enter a valid phone number.
Trine Student Email*
example@my.trine.edu
Major:*
Class Standing:*

FreshmanSophomoreJuniorSenior
Please list the courses you need textbooks or materials for. If you need textbooks/materials for all of your classes, please type "ALL." *
Do you need to borrow a laptop?*

YesNo
Do you need to borrow a calculator?*

Yes - Graphing calculatorYes - Scientific calculatorYes - Not sure what kindNo
Do you need any school supplies? If yes, select all that apply. If no, select "No."

NoPencilsPensHighlightersFoldersNotebooksLoose leaf paperGraph paperBindersNote cards
Financial Information
Did you have to take out a loan for the semester? (For tuition, room and board, etc.)*

YesNoI tried to take out a loan but did not qualify and/or did not have a cosigner
If you did take out a loan, what type is it?*

Public (Subsidized, unsubsidized, Parent PLUS, etc.)Private (Sallie Mae, Discover, SoFi, etc.)Public and privateI don't knowI did not take out a loan
Where do you live?*

On campusOff campus (apartment, rented house, etc.)Sorority or fraternity houseWith parents
Do you have a meal plan on campus?*

YesNo
Some students do not qualify for full assistance but may be eligible to receive partial assistance. If you are not eligible to receive full assistance, what is an amount that you can contribute to your books this semester?*

$0$1 to $25$26 to $50$51 to $100$101 to $150$151 to $200$201+
Agreements and Return Requirement
I understand that this form is a request for assistance and does not guarantee eligibility.*

I agreeI do NOT agree
I understand that I may only be able to receive $600 of assistance total during the calendar year (January 2025 - December 2025).*

I agreeI do NOT agree
Student attendance is monitored via the We Care system. I understand that if I miss more than 20% of the class(es) that I receive assistance for, I may be ineligible for assistance in future semesters. This not not include excused absences.

I agreeI do NOT agree
RETURN REQUIREMENT - I understand that any physical books or electronic equipment I receive must be returned no later than Tuesday, July 1, 2025. I understand that not returning these will make ineligible for future assistance.*

I agreeI do NOT agree
Signature- Please sign form below*

Clear
Today's Date*

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Date
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Summer 2025 - Textbook Assistance Request Form

Financial Information

Agreements and Return Requirement