HPBA Member Employee Disaster Relief Fund Application Survey

Natural disasters are an unfortunate reality, and HPBA recognizes the importance of being prepared to support our hearth, patio, and barbecue community during such times. Rapid response is crucial, and HPBA’s Member Employee Disaster Relief Fund is here to offer assistance when it’s needed most.

If your company is an HPBA member and you or your employees have been affected by a recent natural disaster, you may qualify for support from this fund. Please complete the form below, and an HPBA staff member will reach out to you regarding your application.

For more information, feel free to email info@hpba.org or call (703) 522-0086. Note that eligibility is limited to current employees of HPBA member companies.

1.Please fill out the following about the HPBA member employee affected:(Required.)

Employee Name

Employee Email

Employee Manager/Owner's Name

Employee Manager/Owner's Phone

Employee Manager/Owner's Email

Company Name

Company Phone

Company Street Address

Company City

Company State

Company Zip

2.Please list the natural disaster(s) that the employee experienced (earthquake, flooding, tornado, etc.).(Required.)

4.Is the employee able to return to work?(Required.)

Yes

If they are unable to return to work, when are they expected to return to work?

5.What forms of assistance or support have you received so far (e.g., financial aid, housing, food, or other relief services)? Please include details on any organizations or sources that provided assistance.

6.If you have submitted any insurance claims, please provide detailed information regarding your coverage and the claims made. Include the following:

Types of Coverage: Specify the types of insurance (e.g., property, health, vehicle).

Specific Damages Covered: Describe the damages or losses each claim addresses.

Current Status of Each Claim: Indicate the status of each claim (e.g., pending, approved, denied).

7.What is the best phone number for HPBA staff to contact the affected employee?(Required.)