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The Lemonade Fund Grant Application
The initial purpose of the Public Charity is to provide temporary financial relief for former and present employees during unanticipated or unavoidable financial hardships, military deployment, unforseen incidents such as: a family death, medical aliments, catastrophic events, and natural disasters; as well as distribute funds to other organizations that qualify as exempt organizations under Section 501 (c)(3) of the Code. The Public Charity may also directly conduct other religious, charitable, scientific, testing for public safety, literary, educational and prevention of cruelty to children or animal activities. The Public Charity may conduct such activities to qualify as a public charity.
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Email *
Employee Name *
Store Location *
Phone *
Address *
Last four digits of SSN *
Reason for hardship
Date of incident/hardship
Cost of hardship
Current financial situation
Timing of need
Have you received funds from the lemonade fund in the past?
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The Board will consider:
- Available funds
- Number and needs of applicants
- Documentation of cost of hardship. Example: cost of transmission repair, medical bill, etc.
- Documentation of current resources. Examples may include evidence of financial standing
- Personal interviews

Reasons for Denial of Application:
- Request related to any criminal action. Example: Attorney fees for DUI
- Request related to personal debt. Example: Credit card debt, student loans, alimony or child support
- Funds must go to current or former employee including immediate family members. Exclusions including but not limited to: friends, extended family, in-laws, boyfriends/girlfriends, fiance.

The employee, by signing, gives the Board authorization to analyze the documents, financial statements, manager reports, etc; that will determine the outcome of the application. The Board reserves the right to refuse any application based on the information provided by the employee. All applications will be thoughtfully considered based on the information provided.

Name/E-signature: *
Date: *
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