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Community Health Worker
Community Education Classes
Echocardiography
Electric Power Technology
Emergency Medical Services (EMS)
Food Service Supervisor
Manufacturing Technician Certificate
Medical Coding
Medication Administration
Medication Aide Update
Nurse Assistant (Aide)
Pharmacy Technician
Phlebotomy
Real Estate
Risk Management Institute
Sterile Processing
TEAS Nursing Entrance Exam Review
Transportation Institute (CDL)
Workforce Contract Training
Tutoring Labs
The Zone in Kilgore
Longview North Zone
Writing Studio
Support Services
Accommodations & Disability Services
Library
Instructional Student Support
Mental Health
Mental Health Page
Student Referral
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Counseling
TRIO SSS & EOC Services
Career Services & Career Coaching
Dual Credit
Adult Education & Literacy
Online Programs
December Mini Classes
Zero Textbook Cost (ZTC) Classes
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KC’s Code is 003580
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T.L.L. Temple Emergency Fund
About You
Your Name
(Required)
First
Last
KC Id Number
Your Address
Street Address
Address Line 2
City
ZIP Code
How Can We Reach You?
We would love to chat with you. How can we get in touch?
Preferred Method of Contact
Email
Phone
KC Email Address
(Required)
Email Address
Confirm Email Address
Your Phone
(Required)
Best Time to Call You
(Required)
Select A Time
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12:30 am
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Emergency Help
Please let us know what's on your mind. Have a question for us? Ask away.
Amount Requested from the Emergency Fund
(Required)
Please enter a number from
10
to
500
.
($500 Maximum Allowed)
Please list exactly how the money you have requested will be used and/or what it is for.
(Required)
Do you have insurance (medical, auto, etc.) that would cover all or part of these expenses? *
Yes
No
What efforts have you made to obtain financial assistance from other sources?
I certify that the information provided on this application is true and correct. *
(Required)
Yes, I agree
Do you have documentation of the emergency (such as a police report, medical bill, utility turn-off notice, etc.)? If you answer yes, please attach a copy at the bottom of this form.
(Required)
Yes
No
Attached Documents
Drop files here or
Select files
Max. file size: 256 MB, Max. files: 4.
