Employee Assistance Program

Confidential financial support for employees facing hardship. Request up to $2,000 in emergency assistance or a repayable loan.

How It Works

Loan Request

You complete the Employee Assistance Request Form

Financial Matrix

HR scores your request using the financial matrix

Leadership Approval

Leadership reviews and approves or declines

Loan Agreement

If approved, you sign the Employee Loan Agreement

Employee Assistance Request Form

All fields marked with * are required.

Employee Information

Employee Name *

Hire Date

Job Title

School Code *

Email Address *

Phone Number

Request Type

Emergency Financial Assistance

Password required — click to unlock

Employee Loan

Repayable via payroll deduction

Amount Requested

Total Amount Requested * (Max $2,000)

Maximum: $2,000

Purpose of Request

Explanation *

Amount Needed By

When do you need the assistance by?

Additional Supporting Information

Loan Repayment Terms

Repayment Frequency

Proposed Repayment Duration

Employee Signature

Sign here *

By signing, you certify the information above is accurate.

Employee Certification — I certify that the information provided in this request is accurate and complete to the best of my knowledge. I understand that providing false information may result in denial of assistance and/or disciplinary action.

Confidential — For Internal Review Only. Your request is reviewed by authorized personnel only. Information is kept private and used solely for evaluating your assistance request.

Already submitted a request? Track your status here