Financial Assistance Request Form

You could be eligible for financial relief thanks to a variety of Federal, State, and local funding.

To learn how much you qualify for, complete the form below.

* First Name:

* Last Name:

* Email Address:

*Please confirm your email address:

* Phone Number:

* Are you a Maryland resident?

Yes
No

* Are you a Carroll County resident?

Yes
No

* I'd like to be considered for assistance for the following reason(s):

Loss of job

Reduction in hours / income (self)

Changing careers

Inability to acquire new / better job or skills for a new/better job (self)

COVID-19 impact in household

Other:

* I plan to enroll in the following Workforce Training Certificate:

Carroll Community College

Financial Assistance Request Form