• BRCA Cares Application

  • Burke, Caldwell, or Rutherford County Residents ONLY

  • HOW COVID-19 HAS AFFECTED YOU

  • FUNDS REQUESTED

  • Funds may be used flexibly to support individuals and families with financial disruption directly related to this crisis. We may not be able to fund the entire amount of all requests, but we will try to meet at least some of the needs of each eligible application. Please indicate the amount you are requesting in each of the following areas.

  • HOUSEHOLD INCOME INFORMATION

  • Family Member 1

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  • Family Member 2

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  • Family Member 3

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  • Family Member 4

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  • Family Member 5

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  • Family Member 6

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  • Family Member 7

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  • Family Member 8

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  • MEDIA CONSENT RELEASE

  • I Agree or Disagree to participate in interviews, photography, or videos for the purpose ofhighlighting BRCA CARES Program. This consent grants permission to edit, use and reuse information, photographs, or videos in print, broadcast, or other forms of media. This release applies to all household members.

  • CERTIFICATION OF INFORMATION

  • I certify that all information in this application is true and accurate. I give permission to BRCA to verify all information provided. I understand the BRCA CARES NC program funding is a one-time subsidy to prevent evictions, foreclosures, disconnections of utilities, etc. (related to COVID-19) that does not require repayment. I also understand that the application is not complete without Required Documentation (Employer Verification of lost wages, Income, Utility Info, rental agreement, mortgage statement, etc

  • Clear
  • SUBMIT INFORMATION TO

  • Email
    CARES@brcainc.org

    Mail
    Bl
    ue Ridge Community Action, Inc.
    800 North Green St.
    Morganton, NC 28655

    Fax
    828-759-0288

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