COVID-19 Relief Fund Application

CRITERIA FOR ELIGIBILITY:
To qualify, individuals/families must have been actively employed at the time of the COVID-19 pandemic, and are now experiencing income loss as a direct result of the shutdown. Assistance will be provided in the form of vouchers to participating grocery stores to purchase basic needs such as food, toilet paper, baby formula, diapers, over-the-counter medication, etc. Non-essential items such as cigarettes/nicotine products, alcohol, or non-store gift cards may not be purchased with the vouchers. Please complete the application below to see if you qualify. Application must be submitted by 5 pm Tuesday each week to be eligible for consideration. You will be notified via email by Friday as to the status of your application. 

 
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Please provide an alternate name for food voucher
Number of people in household in each age category:
Please provide employer name. If self-employed please include type of business.

Unfortunately, you are not eligible to apply. Please call 211 for assistance.

Unfortunately, you are not eligible to apply. Please call 211 for assistance.