Jewish Free Loan of Greater Portland COVID-19 & Wildfire Relief Fund Application
Note: This information will be kept confidential, and within the confines of the Jewish Free Loan Committee and Federation staff assigned to this program.
Street Address Line 2
State / Province
Postal / Zip Code
Loan Request (MAX $1,000)
Purpose of the loan:
Are you Jewish or identify as Jewish?
Have you lived in Oregon or SW Washington for the past 6 months consecutively?
Is the need for your loan directly or indirectly attributable to COVID-19 (lost wages, childcare costs due to school closures, small business losses, medical costs, etc) OR the recent Oregon wildfires (loss of housing, evacuation expenses, etc)?
Most Recent or Current Employer
Have you been laid off or had your hours reduced due to COVID-19?
Will you be able to return to work after COVID-19?
By signing this, I: 1. Certify that the information on this application is true and complete as of the below date(s). 2. Agree tat this application is the property of JFLGP and need not be returned to me. 3. Authorizes JFLGP to verify the accuracy and completeness of all information above from any source JFLGP chooses. If I am married or am a registered domestic partner and am applying for this loan in my name alone, this authorization extends to verifying information about my spouse or partner. 4. Authorize JFLGP to answer questions from, and to furnish information to, others about JFLGP’s experience with me and to discuss all aspects of this application and my loan with each person who guarantees my loan.
I/we understand and agree
Applicant Signature and Date
Spouse/Partner Signature and Date (if applicable)
Should be Empty: