Skip to main content
Mobile Main menu
Get Help
About Us
Our Impact
Our Focus Areas
Our Signature Outreach Programs
Annual Report
Get Involved
Events
Calendar
Annual Meeting
Christmas Gala
Day of Caring
Pickleball Tournament
Stuff the Bus
Contact Us
Search
Search
Header Buttons
Donate
Volunteer
Main navigation
Get Help
2-1-1 Helpline for Resources
Hardship Assistance
Emerging Needs
About Us
Mission, Vision, Values, and History
Staff
Board of Directors
Financial Accountability
Workplace Partners
Funded Partners
Agency Portal
New Agency Interest Form
Community Data & Resources
See What We've Been Up To
Our Impact
Our Focus Areas
Our Signature Outreach Programs
Annual Report
Get Involved
Give
Volunteer
Join
Corporate Engagement
Get Our Newsletter
Intern With Us
Events
Calendar
Annual Meeting
Christmas Gala
Day of Caring
Pickleball Tournament
Stuff the Bus
Contact Us
Individual COVID-19 funding request
Applicant Contact Information
First Name
Last Name
Home Street Address:
City:
State:
Zipcode:
Phone w/area code:
Email:
Spouse First and Last Name:
Children - First Names Only - If none, enter NA:
Emergency Contact:
Describe the need and how it will be utilized (i.e., car payment, rent, mortgage, utilities, etc) to improve a degraded quality of life or prevent destitution:
Amount requested from UWLC:
$
Number of people working in the household:
Total Yearly Income:
$
Total Yearly Expenses:
$
Rent or Own Home?
Rent
Own
Have you applied for the following:
Unemployment
Yes
No
If yes, when?
SB Loans
Yes
No
If yes, when?
Payroll Protection
Yes
No
If yes, when?
Have you reached out to other county agencies for help?
Yes
No
If yes, which agencies?
Payment is provided directly to the service provider(s) and is a one-time payment.
1. Service Provider Name:
Phone Number:
Mailing Address
City, State, Zip Code:
Date Payment Due:
Account Number:
2. Service Provider Name:
Phone Number:
Mailing Address
City, State, Zip Code:
Date Payment Due:
Account Number:
3. Service Provider Name:
Phone Number:
Mailing Address
City, State, Zip Code:
Date Payment Due:
Account Number:
Signature
In order for your application to be processed, ALL information provided will be verified. By signing below, I authorize United Way of Lincoln County to contact any individuals/companies listed on my application for verification of information submitted.
Submit
Leave this field blank
