Grant Application

*Please note the following general criteria governing grant applications:

  • It may take up to 30 days for your grant to be processed.
  • The maximum grant amount is $2,000 for an individual grant and $3,500 for the lifetime of an individual applicant or applicant's immediate family.
  • We pay the awarded amount to a third party, such as a doctor, utility provider, landlord or mortgage lender, or the like. We do not give cash directly to the grant recipient.
  • A grant applicant whose application is approved may not apply for another grant for at least 30 months after the first grant is awarded.
  • A grant applicant whose application is declined may apply again twelve months after the date of the first application.

To expedite your grant approval please upload the following documents along with your grant application:

  • Last Year's Tax Return
  • Bank Statements for the past three months
  • Driver's License or other form of identification
  • Any documentation demonstrating the nature of your crisis or need
  • Bill/Bills for the third party to whom you would like the grant to be paid 

Please understand that your application will not be considered complete and will not be reviewed by the Grants Committee until you have provided all information required by the application and all documents listed above and requested by the Committee.

Grant Application

Please respond with your combined family income:
____under $20,000 ____ $20,001 – 30,000 ____ $30,001 – 40,000
____$40,001- 50,000 _____ $50,001 – 65,000 _____ above $65,000

Single Parent?
Has there been a job loss?
If this is a medical crisis?
Do you have medical insurance?
Are you receiving any financial help from extended family, friends, or church?

Please provide us with a brief description of your need:

Please upload any supporting documentation you may have to support your request

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I certify that the information provided herein is true and correct to the best of my knowledge. I understand this information will only be reviewed by appropriate Board members and no medical or personal information will be made public without my consent.

Please respond Yes to confirm your agreement
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    *Enroll in the Community Award number 61712.

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