Can I answer yes to the questions below? 

I am a: 

• Full time employees (defined as those who work a minimum of 35 hours per week)
• Part time employee

Has the event occurred within 6 months  of your application? 

Is this the first time that I’m applying for a grant, or has it been 6 months since I last applied for a grant? 

Is the event for which I’m requesting a grant listed below? 

• QUALIFIED DISASTER: These events include state or federally declared disasters, disasters resulting from common carrier accidents, and disasters that result from a terroristic or military action.
• DEATH OF EMPLOYEE OR THEIR IMMEDIATE FAMILY MEMBER: This includes the death of the employee, spouse, or eligible dependent(s). The loss of income or the cost of funeral expenses or medical bills must significantly impact the family’s resources. The Fund may also be able to pay expenses to bring a child whose parents have died to live with a new family, typically a relative. The Fund cannot pay for travel to funerals, caskets, grave markers or other funeral expenses.
• NATURAL DISASTERS: Situations such as a wildfire, flood, tornado, hurricane, severe storms or earthquake that have damaged or destroyed the employee’s primary residence. The Fund cannot pay to repair other property and cannot pay to replace non-essential items, e.g. electronics, etc. Photographs and/or insurance reports may be required.
• SERIOUS ILLNESS or INJURY, or NON-ROUTINE/EXCEPTIONAL MEDICAL EXPENSE: The Fund is not a substitute for medical insurance; employees do not automatically qualify for a grant when they, or their dependents, are diagnosed with or suffer a life-threatening or serious illness or injury. There must be resulting financial need placing significant pressure on the family’s financial resources. Doctor confirmation and/or medical documentation will be required.
• DOMESTIC ABUSE: This is a situation that causes the employee and other victims to leave an unsafe residence.
• IMPACTS TO PRIMARY RESIDENCE: This includes but is not limited to: fire, flood, etc causing major home damage that could not be prevented that significantly impacts the family’s resources. Police, fire, or other official incident report may be required.
• VICTIM OF A VIOLENT CRIME: This includes a serious crime against the employee (robbery, arson, assault or other reportable crime) that significantly impacts the family’s resources.
• MILITARY DEPLOYMENT: In the time of a natural disaster or national emergency, the employee, spouse or domestic partner is unexpectedly or unavoidably called to active duty from the military reserves or National Guard.

Is the hardship you are facing listed below? 

• Food, Clothing, and Housing: immediate needs only applicable up to 30 days after the Event
• Mortgage or Rent assistance for primary residence: generally for a period beyond 30 days
• Essential appliances and furnishings
• Reasonable repairs to damaged property
• Essential utility expenses
• Security deposits for new housing if unable to inhabit existing home
• Reasonable evacuation expenses
• Reasonable funeral, travel, and burial expenses
• Car repairs other than routine maintenance, or repairs that could not have been reasonably avoided
• Cost of Car rental or public transportation for up to 30 days
• Medical expenses not covered by insurance, including prescription medication
• Psychological counseling deemed by a physician to be necessary following an event and in excess of what is covered by insurance
• Expenses resulting from flight from domestic violence, such as temporary housing
• Unable to work due to the event
• Unexpected child care up to 60 days

Is the grant amount you are requesting between $500 and $3,500?