Application for Assistance

APPLICATION FOR ASSISTANCE

One of the primary missions of West Slope Foundation is to identify and meet the immediate and long-term needs of the Caldor Fire Survivors. We wish we could help everyone who was impacted by the wildland fire, but unfortunately there is not sufficient funding, so certain requirements have to be met to qualify for assistance.
Please, check all of the statements that apply to you or your household.
West Slope Foundation uses the answers above to triage your application, and prioritizes households living in recreational vehicles, or unstable living environments. If we are unable to directly assist you at this time, we will always look for resources or services that might be able to help. We will always be here if you find yourself in need of help, regardless of where you are on your rebuild journey.

Household Contact Information
Your Name

First NameLast Name
Email
example@example.com
Primary Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Applicant or Alternate Contact Name (this includes a spouse, partner, or roommate)

First NameLast Name
Co-Applicant Primary Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Applicant Secondary Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Applicant or Alternate Contact Email
example@example.com
Relationship to Applicant

Damaged Home Information

In this next section we will ask you several questions about your home that was damaged or destroyed.
Physical address of the home damaged by the Caldor Fire.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Damage to Residence
Residence Use
Residence Type
Own or Rent
Did you have insurance?
If you have insurance, does it cover displacement costs?
If you have insurance, please provide the contact information below.
If Applicable: Please Upload Your Insurance Policy Declarations Page

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Are you planning on returning to your property?
If you answered Unsure or No above, please explain.

Wrap Up

In this next section we will ask you several questions that will help us understand who we can share this application with. We only share information with partners and other organizations/agencies that work directly with disaster and survivor needs. We will never share your information with anyone outside of the Caldor Fire Resource team.
Are you currently working, or have you worked with an agency or organization for disaster assistance?
If yes, please indicate who you are working with.

Other
Would you like to partner with a disaster case management to help navigate your recovery?
May West Slope Foundation share your application with other entities that may be able to provide additional resources and support?
By clicking yes your information will only be shard with other organizations and agencies helping to fulfill the needs of the Caldor Fire Survivors. By clicking no, West Slope Foundation will not be able to share your information with other resources that would be able to help guide you through the recovery process.
Does West Slope Foundation have your permission to use any photographs or video that may be taken at events, or your address, of you, your family, or your physical location for informational pieces?
Please provide a picture of your Driver's License or ID

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Signature and Affirmation: By Signing and Submitting this Application, I Certify all Information Provided is True and Correct, and I Understand That all Information Provided will be VALIDATED by Independent Investigators.
Should be Empty:

APPLICATION FOR ASSISTANCE

Household Contact Information

Damaged Home Information

Current Housing/Living Situation

Current Needs

Wrap Up