Covid 19 Assistance Application / Solicitud de asistencia Covid 19

Covid-19 Assistance Fund Application

All requests must include proof of current or previous employment impacted by COVID-19. Assistance may be provided for essential services that have been impacted by decreased work hours.

Todas las solicitudes deben incluir prueba de empleo actual o anterior afectado por COVID-19. Se puede proporcionar asistencia para servicios esenciales que se han visto afectados por la disminución de las horas de trabajo.
Primer Nombre ---------------------------------------------------------------------- Apellido

Covid 19 Affected Employment / Empleo Afectado por el Covid - 19

* Provide backup / Proporcionar copia de seguridad

FOR SELF EMPLOYMENT, PLEASE FILL OUT THE SELF EMPLOYMENT STATEMENT WHICH IS LOCATED UNDER GRAYS HARBOR COUNTY ON THE PREVIOUS

PAGEPARA EL EMPLEO PERSONAL, POR FAVOR LLENE LA DECLARACIÓN DE EMPLEO INDIVIDUAL QUE SE ENCUENTRA BAJO EL CONDADO DE GRAYS HARBOR EN LA PÁGINA ANTERIOR

Assistance Requested * Asistencia solicitada (UP TO $750 in assistance)

* MUST PROVIDE copies of bills to pay ** Proporcionar copia de facturas

Documentos requeridos

Estos documentos son necesarios para procesar su solicitud:
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
Click or drag a file to this area to upload.
pdf or jpeg
If you need to provide more files, send to jenniferm@coastalcap.org with "Covid-19 Funds Application Additional Docs" in the subject line.