HCAR Cares "In This Together" Funding Request Application

In recognition of the incredible effort ahead of Howard County and the world to recover from the devastating impact of COVID-19, the HCAR Cares Board of Directors is accepting applications for financial relief from the "In This Together Fund." Any businesses, charitable organizations, or individuals who require financial assistance to recover from situations related to the COVID-19 pandemic are encouraged to apply. The HCAR Cares Board of Directors will award financial relief based on need and availability of funds. Financial assistance is limited, and not all who apply will be awarded funding.

CRITERIA:

* APPLICATION DEADLINE: SUNDAY, AUGUST 9, 2020.

* Applicants/awardees must reside or be based in Howard County, Maryland.

* Applicants must be at least 18 years of age.

* Applications may be submitted on behalf of any individual, business, or charitable organization.

* Successful applications will be based on need directly related to the COVID-19 pandemic.

Applications must be completed in full and signed by the requesting party.

Please note that you are unable to save your progress on this application, so please review all of the questions, gather your responses separately, then complete and submit this application. If you have any questions, please contact Sarah Rayne at hcarcaresmd@gmail.com or at 410-980-0443.

For more information about HCAR Cares, visit www.hcarcares.org.

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* 1. Date

Today's Date

Date

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* 2. Your Name

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* 3. Your Phone Number

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* 4. Your Email Address

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* 5. Name of organization, program, or individual to receive funding

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* 6. Your relationship to the funding recipient

I am a representative of the organization or program.

I am applying on behalf of the organization, program, or individual.

I am the individual recipient of these funds.

Other (please specify)

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* 7. Name and contact information for the organization, program, or individual.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 8. We would like to send you our quarterly e-newsletter. If you do not wish to receive our newsletter, please check the box below.

Opt Out

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* 9. If you are applying on behalf of an organization, program, or individual, are they aware you are making this application?

Yes

I am applying on my own behalf

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* 10. Please describe the need for funding as it pertains to the COVID-19 pandemic, as well as how the funding will be utilized.

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* 11. Amount Requested (Please note that you may be approved for an amount other than the one you request here, at the discretion of the HCAR Cares Board of Directors.)

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* 12. Supporting Documents 1

Please upload supporting documents in the next 3 questions, if you wish. You may only upload one file per question.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 13. Supporting Documents 2

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 14. Supporting Documents 3

If you would like to provide more than three supporting documents, please email it to hcarcaresmd@gmail.com, and specify that it should accompany your grant application.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 15. By signing below, I acknowledge all the information provided in this application is accurate to the best of my knowledge and I release this information for consideration by the HCAR Cares Board of Directors. I also acknowledge that funding is limited and not all who apply will be awarded financial assistance.