COVID-19 Impact Form

Please fill out this form if your education or training was negatively impacted by COVID-19 from Jan. 1, 2020, through Dec. 31, 2022.

A COVID-19 Special Consideration request will be considered if you are not meeting the 2.5 cumulative GPA requirement or did not complete your previously funded coursework. Please respond as soon as possible, you do not need to submit an application to turn in this form.

If you are not planning to continue coursework or training at this time but were impacted by COVID-19, please submit the impact form so documentation is on file if you decide to apply in the future.

You may also download a Word version of this form here and upload it to your online account. Submissions will be reviewed in the order they are received, thank you for your patience as we remotely process hundreds of replies.

If you are seeking assistance from CIRI’s Direct Assistance Program, please visit and apply at ciri.com/CARES. The CIRI Foundation is not administering funding for CIRI’s Direct Assistance Program. This form is only for previously funded students whose grades or enrollment status were impacted by COVID-19.

Name *

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1. What changes or difficulties occurred during your term, or training, as a result of COVID-19? Please include start and end dates for impacted coursework. *

2. Did your enrollment level specifically change? (e.g., full-time to part-time, number of credits, etc.) *

3. Was there any portion of your coursework, or programming, that you were not able to complete? If so, what coursework was not completed? Please explain why you were unable to complete the coursework or program. *

4. Did your school or institution communicate a course of action or plan directly to you, or campus-wide, to address changes resulting from COVID-19 such as grading or credit polices? (Example: but not limited to, classes moving from letter merit grades to pass/fail only) *

5. Is there any additional information you’d like TCF to be aware of related to your funded coursework and COVID-19 impacts? *

Name

Action: Please submit this form now. TCF will contact you regarding your specific situation and may request further documentation. Any supporting documentation can be submitted to TCF later.

Examples of documentation that may be requested include emails or documents from the institution, administration or instructors that discuss class changes, course availability, campus housing, transitions to online coursework, moving to a pass/fail grading system, academic advisement, etc.

TCF COVID-19 Impact Form updated 5/6/2022.