Salt Fund Nomination Form
*Nominations are reviewed by the Salt Council and are approved based on the availability of funds.
*A recipient may only be awarded assistance from the Salt Fund once a year.
*The council may request additional information to assess needs and maintains full discretion.
*Please note that payments for bills will be made directly & we will contact you for a copy of the bill.
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Your Name (Will be kept anonymous) *
Your Phone Number and Email Address (in case we have questions about the nomination) *
Who are you nominating?   *
Are you related to the nominee? *
Tell us about the nominee & the urgency of the need. Provide as many specifics as you can (i.e. single parent, childcare, utility bill overdue, vehicle maintenance, rental assistance, medical issues, job loss, or simply needs encouragement): *
Nominee's Mailing Address *
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