Scrubs Program

Application Information

First Name

Last Name

Baylor ID Number

Email Address

Year at Baylor

Are you an International Student

Other Student Explanation

For what program do you need these scrubs?

Date of the event

mm/dd/yyy

What type of scrubs do you need

Sizes need for the selected items

Please use U.S. sized

Your individual monthly income

Not your family or parent's income

What life circumstance brings you to The Closet

Please select all that apply

Not enough money for attire

Lack of transportation to the store

Financial situation has changed

Unexpected expenses

Other

Other circumstance

Data Purpose Questions Only

The following questions are for data purposes only and do not impact your ability to access the Campus Closet: Professional Attire Program.

How often has the following statement been true for you this semester so far or last semester? 'The food I bought didn't last, and I didn't have money to get more

Let us know if the statement is true

Other Explanation

Have you been skipping meals or eating less than you need because you didn't have enough money to buy food?

Let us know if you have been skipping meals

Other Explanation for Skipping Meals

So far this semester (or last semester), have you ever had to go a whole day without eating because you didn't have enough money to buy food?

Let us know if gone a whole day without eating

Other Explanation for not eating

Do you have the resources to purchase the materials you need (laptop, calculator, textbooks, etc.) for classes this semester?

Do you have the resources to purchase needed materials?

Other explanation about materials resources

In the last 30 days, did you have difficulty paying your rent or mortgage?

Do you have difficulty paying your rent/mortgage

Other explanation about paying rent/mortgage

Do you have reliable transportation to school, work, and/or basic needs resources

Let us know if you have reliable transportation

Other Explanation for reliable transportation

Let us know if you have difficulty accessing healthcare

Do you have difficulty accessing healthcare?

Other explanation concerning healthcare

Let us know if you have difficulty accessing mental healthcare

Do you have difficulty accessing Mental healthcare

Other explanation concerning mental healthcare

Let us know if you are a parent or caregiver.

Are you a parent or caregiver

Other caregiver explanation

How did you hear about the Graduation Regalia Program

Is there anything else you'd like us to know about you

Scrubs Program

Paul L. Foster Success Center