Grant Application - Golden Rule Charity

CONTACT INFORMATION

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Status

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Date

Name(Required)

First Name Last Name

Phone(Required)

What's your best phone number?

Email(Required)

Please enter and then confirm the email you would like to use for correspondence moving forward.

Enter Email Confirm Email

Address(Required)

Street (47 Peach Blossom Street, Apt. #15D) City State ZIP Code

County of Residence - Select One(Required)

If the county you reside in is listed below, please select it. Otherwise, select (My County is Not Listed)

Birthdate(Required)

You must be at least 18 years old to apply for a grant from Golden Rule Charity

Permission to use your story to help raise awareness for GRC?(Required)

May we use your story for future public relations and fundraising? We will not disclose your email, phone number, street address, or any specific financial info.

How did you hear about Golden Rule Charity? Please select from the following options.(Required)

PREVIOUS APPLICATIONS TO GRC

Applied to GRC Before?(Required)

If so, did you receive assistance?(Required)

When did you apply?(Required)

MOST RECENT EMPLOYMENT INFORMATION

You must have worked at least six months in the hospitality industry immediately preceding this application date to qualify for assistance during our current grant cycle.(Required)

What was your Job Title at your most recent place of employment?(Required)

Time in the Hospitality Industry(Required)

How many years (combined) have you worked in the Hospitality Industry across your various jobs?

Current Place of Employment(Required)

What is the name of the business where you are employed?

Employer Address(Required)

Street Address Address Line 2 City State ZIP Code

Business Website

Type of Business(Required)

Please select the type of business that is the closest match.

Business Type (Other)(Required)

Please provide the Business type if "Other" was selected from the previous dropdown.

Manager/Owner's Name(Required)

Please provide the name of your previous supervisor or the owner of the establishment at which you worked.

Manager/Owner's Contact Info(Required)

Please provide the best way to contact them.

HARDSHIP DETAILS

Current hardship must have occurred during the past 60 days prior to the current open grant cycle to qualify for assistance.

Date of Disaster or Financial Hardship(Required)

Disaster Type or Source of Hardship(Required)

Disaster or Hardship (other)(Required)

Please provide the Disaster Type or Source of Hardship if "Other" was selected from the previous dropdown.

Description of Hardship(Required)

Please provide context to your current hardship.

ESTIMATED NEEDS

What financial needs have arisen as a result of the above Disaster or Hardship? If you have no need of assistance for a given category, enter "0".

Estimated Medical Need(Required)

How much do you need to help pay your medical bills, prescriptions, doctors appointments, hospital visits, etc.?

Estimated Housing Need(Required)

How much do you need to help pay your rent, mortgage, or property taxes?

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Estimated Groceries Need

How much do you need to help put food on the table?

Estimated Utilities Need(Required)

How much do you need to help pay your utility bills for Water, Trash, Sewage, Electricity, etc.?

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Estimated Education Need

How much do you need to help pay for ongoing education or student loans?

Estimated Phone or Internet Need(Required)

How much do you need to help pay your Phone or Internet bills?

Estimated Public Transportation Need(Required)

If Public Transportation (for everyday life, not travel) is essential to you, how much do you need to help pay your fees for use of buses, metros, or trains?

Estimated Personal Vehicle Need(Required)

If your personal vehicle is essential, how much do you need to help keep it fueled, insured, registered, and functional?

Estimated Small Business Need(Required)

If you own or operate a small business in the Hospitality Industry, how much do you need to to resolve the Disaster/Financial Hardship to your business in order to continue to operate and retain your employees?

Other Possible Needs(Required)

If there is an additional need not listed above, it may be present in this list. Please note that only (1) need from this list can be selected.

Estimated Amount of Other Need(Required)

List the amount needed in relation to the option selected in the above "Other Possible Needs" field.

DIVERSITY AND INCLUSION

Individuals seeking a grant from Golden Rule Charity are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation. You are being given the opportunity to provide the following information in order to help us comply with federal and state Aﬃrmative Action record keeping, reporting, and other legal requirements. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the grant process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

Race and/or Ethnicity

Gender

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GRANT APPLICATION OPPORTUNITY – ORANGE COUNTY, CALIFORNIA

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CONTACT INFORMATION

PREVIOUS APPLICATIONS TO GRC

MOST RECENT EMPLOYMENT INFORMATION

HARDSHIP DETAILS

ESTIMATED NEEDS

DIVERSITY AND INCLUSION

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CONTACT INFORMATION

PREVIOUS APPLICATIONS TO GRC

MOST RECENT EMPLOYMENT INFORMATION

HARDSHIP DETAILS

ESTIMATED NEEDS

DIVERSITY AND INCLUSION

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