Please enable JavaScript in your browser to complete this form.Personal Information – Step 1 of 10ISCN – Student Financial Assistance ApplicationPlease fill all fields. After you submit this form, email with the information you provide will be sent to head of social services. You can follow about the status of your application by contacting social services at ss@coronamuslims.com or by calling social services at (951) 523-7645.Name *FirstLastEmail *Phone *Other Phone (optional)NextMarriage Status *SingleMarriedDivorcedWidower/WidowSpouse Name *FirstLastEx-Spouse Name *FirstLastDeceased Spouse Name *FirstLastNumber of family members *1234567 or morePreviousNextAddress *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAre you renting or own your residence? *OwnRentalPreviousNextRequested Amount *Applying for *Zakat Ul MaalSadaqaFitraThe donation I will get will be used for *School Tuition FeePreviousNextPlease provide name, your relationship with the person, age and monthly income on each person living in the household in the paragraph below. *Please provide two personal references below. Please provide name and phone number. *PreviousNextAre you or any member of your household receiving any kind of help from Government or Non-Government organization? *YesNoIf you selected yes to above question, provide the amount you are receiving. *PreviousNextPlease check all that applies *I am over 18 years oldOnly one member of the family can apply at a time.Provided photo IDResident of Inland EmpireFile Upload Click or drag a file to this area to upload. Briefly describe the reason for your request and attach supporting documents. *PreviousNextDeclaration *Yes, I have read and accepted the termsNo, I do not consentSince you are submitting this application electronically, you the undersigned hereby declare that all the information above is true and correct to the best of your knowledge, Allah (SWT) is my witness. Disqualification *Yes, I have read and accepted the termsNo, I do not consentI also understand that any sort of false statement or misrepresentation of facts may disqualify me from any future help from ISCN.Signature * Clear Signature PreviousNextIslamic Society of Corona Norco (ISCN) Financial Assistance Background Check Policy *Yes, I have read and accepted the termsNo, I do not consent Purpose The Islamic Society of Corona Norco (ISCN) is committed to providing financial assistance to those in need while ensuring that funds are distributed fairly and responsibly. This policy outlines the process for conducting background checks on applicants seeking financial aid. Scope This policy applies to all individuals seeking financial assistance through ISCN. Background Check Requirements Identity Verification: Applicants must provide a valid government-issued ID (e.g., driver’s license, passport, or state identification card) and proof of residence. Financial Assessment: Applicants may be required to provide proof of financial hardship, including but not limited to: Recent pay stubs or proof of unemployment Bank statements (last three months) Utility bills or rental agreements Any other supporting documents requested by ISCN Criminal Background Check: ISCN reserves the right to conduct a criminal background check in cases where additional verification is deemed necessary to ensure the integrity of the financial assistance program. Community References: Applicants may be asked to provide references from community members, religious leaders, or social service organizations to verify their need for assistance. Prior Assistance Review: ISCN will maintain records of prior financial assistance provided and may review an applicant’s history before approving additional aid. Confidentiality All information collected during the background check process will be kept strictly confidential and used solely to determine eligibility for financial assistance. Consent Applicants must provide written consent to undergo the background check process as outlined in this policy. Failure to provide consent may result in the denial of financial assistance. Decision Process Applications will be reviewed by a designated ISCN Financial Assistance Committee. The committee may conduct interviews or request additional documentation as needed. Applicants will be informed of the decision within a reasonable timeframe. If an application is denied, the applicant may appeal the decision by submitting a written request for reconsideration with additional supporting documents. Compliance and Ethical Considerations ISCN will ensure that the background check process is conducted fairly, without discrimination, and under all applicable laws and ethical guidelines. Policy Review This policy will be reviewed annually and updated as necessary to align with community needs and legal requirements. Effective Date January 01, 2021 Approved By Social Services Committee & Board of Directors Financial Assistance Background Check Policy Consent Signature * Clear Signature PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
