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APPLICATION FOR FINANCIAL ASSISTANCE


Please fill out the following application if you believe you meet the necessary guidelines for Southern Smoke’s Emergency Relief Fund. One of our case managers will be in touch as quickly as they can.

Guidelines: All applicants must be currently working in the food & beverage industry full-time (30+ hours per week) for a minimum of six consecutive months.

Case managers are assigned to cases based on the urgency of the crisis and not on a first-come-first-served basis. For instance, life-and-death cases are prioritized. All cases are reviewed and assigned a level of urgency upon submission.

Para la aplicación en español haga clic aquí


EMERGENCY RELIEF GRANT PROCESS


  1. Employment verification - confirmation of 6 months working in the industry at 30 hours a week via paystubs and employer verification
  2. Discovery - the case worker builds the case by collecting supporting documentation 
  3. Review - the case is reviewed by the awards committee, representing a diverse selection of industries 
  4. Decision - if awarded, the grant will be sent directly to you via ACH 
Date of Birth*
When did you begin your current job?*
Work ZIP Code*

Statement of Need: Please describe your crisis and reason for applying. The statement must be included to be considered.

Please include any of the following if applicable:

  • How much work have you missed as a result? 
  • How much income have you lost due to the crisis? 
  • Any loss or damage to personal property
  • Injury or Loss of an immediate family member or loved one 
  • Any unforeseen expenses including medical expenses, childcare expenses, etc.


Please attach copies of your most recent paystubs and/or any supporting documentation for expenses you seek assistance with (e.g. lease, eviction notice, medical bill, utility statement).

Most Recent Paystub
No File Chosen
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Bill/Invoice/Statement
No File Chosen
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Disconnection/Eviction Notice
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Housing Lease/Mortgage
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I certify that all of the information I provided in this form (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of funding and immediate disqualification regardless of the timing or circumstances of discovery.*
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