Employee Emergency Fund

Employee Emergency Fund - SWCares

Southwest (Banner) ID*

Name*

Address*

Cell Phone*

Phone

Work Phone

Phone

Email*

Work Location*

Department*

Title*

Date of Birth*

NOTE: Incomplete requests will not be processed. Supporting documentation and signatures are required and must be submitted with the application (examples of acceptable documentation are eviction/foreclosure notification, utility cutoff notice, policy/fire report, funeral expenses invoice and doctor's note). Documentation must be on letterhead. If you live with someone and are not the property owner, but are responsible for expenses at the property, an official statement from the property owner must be submitted also.

1. Please describe your emergency and circumstances in detail (including all dates). Attached documents to show proof of need, for example, a cut-off notice from MLG&W.*

2. Amount of financial assistance requested from SWTCC Foundation*

Provide documents or photos of overdue notices, bills, or any other proof that you are in need.*

Documentation is Required

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