Have you been financially affected by COVID-19?
DO NOT FILL OUT THIS FORM IF YOU HAVE NOT YET SPOKEN WITH AN ARK VOLUNTEER.
Please fill out this form to apply for financial assistance if you have suffered a loss of income due to the economic impact of the Coronavirus. After completing this form, you will be asked to send in documentation verifying your loss of income. YOU MUST CALL THE ARK AFTER YOU HAVE SENT YOUR DOCUMENTATION IN ORDER TO SCHEDULE A VIRTUAL APPOINTMENT FOR ASSISTANCE. ***Funds are limited: If we do not hear from you within 2 weeks of submitting this form, we will assume you no longer need the assistance, and your application will be removed from the queue so we can better assist those in need.
Have you ever been to the Ark before for financial assistance? *
Which county do you live in? (The Ark only serves the follow counties: Clarke, Oconee, Madison, and Oglethorpe unless you are Publix employee) *
First and Last Name *
Your answer
Phone Number *
Your answer
Email Address
Your answer
Date of Birth *
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Employer Name and Contact Info (Email or phone) *
Your answer
Reason for financial assistance *
Has your employer filed for unemployment benefits on your behalf? *
What bill(s) do you need help with? Please select all that apply. **Selecting a bill does NOT automatically qualify you for assistance. You must meet Ark guidelines and needs will be met according to availability of funds. *
Required
For bill assistance, please check off below that you will email us the following documentation to: arkumocdocs@gmail.com or FAX 706-353-1153: (Select all that apply to YOUR circumstance) *
Required
NEWS YOU CAN USE! Please visit the following links to learn what additional resources and strategies are available to you during these tough times! If you know of additional resources, please click Other and add your resource!
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