Emergency Assistance for TWB Alumni Team Members

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Please share as much information as you can in the form below. This info will be shared with our Executive Board who has the decision making authority for our emergency fund distribution. Emergency funding is based on funds available and specific criteria. We aim to respond to this request and complete the eligibility process within 72 hours. Thanks and we hope we can help.

We will need documentation of upcoming bills (copies of lease, invoices, bills, etc.). Payment will be made directly to the company.

Email *

Name *

Phone number *

Please list the members of your household and their employment status. Ex. boyfriend, working full time; Child, age 10, student, etc. *

What is the nature of your emergency situation related to coronavirus? *

Loss of employment related to coronavirus

Loss of Housing related to coronavirus situation

Food insecurity related to coronavirus

Child care needs related to coronavirus

Medical emergency related to coronavirus

Other:

Required

Please explain your current situation chosen above. For example, children need breakfast and lunch due to school closings. *

Have you or has someone in your household tested positive for coronavirus? *

If loss of employment, have you applied for unemployment? If so, which state? *

Any other information you can share that may be important to consider in making this decision? *

Send me a copy of my responses.

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