LLK Foundation Financial Assistance Application Form

Application for Assistance

Operation Helping Hand - Emergency Assistance plan to do community service work and serve families in underserved communities. We provide funding while it lasts. It is always limited, and many of us rely heavily on donations from individuals and businesses in the local community. Financial assistance is issued with conditions and is usually offered when a family is faced with a crisis. Homeowner's Repair Program assist in finding the resources to repair your home. We will also provide funding for small jobs while funds are available.
- For individuals who are in a crisis.
- 1 award per family.
- Awards granted upon evaluation on a first-come, first-served basis.
- Assistance will be awarded while available funds are exhausted.
- Application does not guarantee that anyone will receive a payment or benefit.
- LLK Foundation is not responsible if receiving these funds precludes an individual from receiving funds from another source.
- Must be a homeowner for small repairs.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Last 4 of Social Security
Date of Birth
Do you have an immediate need?*

YesNo
Check all that apply:

Self-employedIndependent ContractorSalariedCommission only
How many members are in your household & what are their names and ages?
Are you willing to pay it forward when someone else is in need when possible?*

YesNo
Are you willing to volunteer & assist us in helping others in need?*
Are you working during this time? Please explain:*
Are you receiving assistance from any other source? If yes, please explain:*
Have you applied for unemployment benefits in North Carolina?*

YesNo
If no, see link below if you desire assistance.
Please explain how you have been impacted by COVID-19 and how you will put these funds to use:*
Amount of funds requested (Evaluated):*
Awarded funds will be paid directly to the business or company for services unless otherwise stated.
Date*

MonthDayYear
Date
Signature*

Clear
Additional Resources
- Apply for North Carolina Unemployment
  https://des.nc.gov/apply-unemployment
  - If you are out of state, we can provide resources for your state of residence.
Should be Empty:

Application for Assistance