Please read before filling out this form.
Each Core Organizer and Staff Member has access to $2,000 per year in emergency support. This can be accessed twice in a calendar year.
What is an Emergency? (Qualifying Use) (Please Reference the Approved Policy for Complete Details)
-Loss of Place of Living (Due to Accident or Eviction)
-Unexpected Non-elective Medical Costs
-Risk of Eviction or Utility Shut Off including Back Rent or Mortgage Payments
-Recovery from Significant Accident, Catastrophe or Theft
-Funeral Expenses
-Back court fines or fees to prevent incarceration or more court involvement
What is not an emergency
-Cosmetic dental or medical procedures including braces; elective surgeries
-Credit card bills and non-mortgage loan payments
-Travel for leisure or pleasure
-Upgrades of old cell phones or laptops
In order for your request to be considered, please have a signed W9 and supporting documents prepared. Staff members will receive emergency support as a bonus to their paycheck.
Examples of documentation needed: Copy of signed lease; signed W9 from landlord; copy of most up to date utility or phone bill; recent statement of court fines & fees owed. Bills, invoices, leases, and agreements should include directions for payments. Documentation is required for everything but grocery, child care, baby items, and clothing requests.
Please upload the documentation below before you click submit.
Please click here to download the W9 form and uploaded below before you click submit.
Each Core Organizer and Staff Member has access to $2,000 per year in emergency support. This can be accessed twice in a calendar year.
What is an Emergency? (Qualifying Use) (Please Reference the Approved Policy for Complete Details)
-Loss of Place of Living (Due to Accident or Eviction)
-Unexpected Non-elective Medical Costs
-Risk of Eviction or Utility Shut Off including Back Rent or Mortgage Payments
-Recovery from Significant Accident, Catastrophe or Theft
-Funeral Expenses
-Back court fines or fees to prevent incarceration or more court involvement
What is not an emergency
-Cosmetic dental or medical procedures including braces; elective surgeries
-Credit card bills and non-mortgage loan payments
-Travel for leisure or pleasure
-Upgrades of old cell phones or laptops
In order for your request to be considered, please have a signed W9 and supporting documents prepared. Staff members will receive emergency support as a bonus to their paycheck.
Examples of documentation needed: Copy of signed lease; signed W9 from landlord; copy of most up to date utility or phone bill; recent statement of court fines & fees owed. Bills, invoices, leases, and agreements should include directions for payments. Documentation is required for everything but grocery, child care, baby items, and clothing requests.
Please upload the documentation below before you click submit.
Please click here to download the W9 form and uploaded below before you click submit.