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Foundation Application-Disaster Relief
Name
Name
Contact Information
Email
Phone
Mailing Address
Address
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
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Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
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Washington
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Wisconsin
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ZIP/Postal Code
Is this your primary place of residence?
Yes
No
Are you the property owner?
Yes
No
Is the property insured?
Yes
No
Source of Personal Income
List Other Members in Household
Please inlude the age, relatioinship and employer for each household member
List Other Members in Household
List Other Members in Household
Item weight
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Remove
Add
Add more items
more items
Amount of Grant Request
Description of Damage
Please indicate what was lost including when, where and how.
Is the individual or family receiving any other form of assistance or aid for the above stated request?
Yes
No
If yes, please list funding source(s) and amount
If no, type "n/a"
Are you requesting funds from other source(s)?
Yes
No
If yes, please list funding source(s) and telephone number(s)
If no, type "n/a"
Please indicate a brief budget for this project
Have you previously applied for funding from the Central Community Foundation?
Yes
No
Applicant Signature
By signing below, you affirm that the information presented on this application is accurate. (Applications that are not signed will not be processed or considered by The Central Community Foundation board of directors)
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Warning message
Additional information may be required. Any of the following additional information may help expedite the processing of your grant request: photos of the damage, letters from organizations such as police departments or the American Red Cross verifying the loss, etc. Incomplete applications will not be processed.
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Your Service
Sign Up for Service
Payment Options
SmartHub
Understanding Your Bill
Frequently Asked Questions
Energy Solutions
Backup Generator Program
Residential Energy Audit
Electric Vehicles
Solar
Rebates
Outage Center
Report an Outage
Outage Map
How Central Restores Power
Preparing for an Outage
Using a Backup Generator
Community
Co-op Connections
Operation Round Up
Co-op Kids
Youth Programs
Safety First
Don't become a DIY accident victim
GFCIs keep you safe while doing outdoor chore
Padmount Transformers Not A Blank Canvas
Power Line Safety
Stay away from downed power lines
Cooperative
Our Mission, Vision and Values
Management Team
Board of Trustees
Board District Map
Board Governance
District 1
District 2
District 3
District 4
District 5
District 6
District 7
History of Central
Resources
Membership Forms
Annual Report
Bylaws
Terms and Conditions
Rates
Vegetation Management
Working crew location map
Construction Timelines
Empowered Newsletter
Used Poles
Careers