Application for Assistance

Grand Love Application for Assistance
Grand Love is honored to support grandparents raising their grandchildren. Our assistance programs are designed to help cover unexpected expenses related to raising your grandchildren such as school activities, clothing, school supplies, and other essential needs. Please complete this application thoroughly. Providing as much detail as possible will help us better understand your family's situation and how we can best serve you. All information submitted will remain confidential.
Name

Grandparent's First NameGrandparent's Last Name
Email
example@example.com
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Phone Number

Area CodePhone Number
Monthly Household Income
Total Number of People in Your Household
Are the biological parents involved with the grandchildren? If so please explain their involvement.

How Many Grandchildren Are You The Primary Caregiver of?
Name of Your Grandchild

First NameLast Name
Birth Date of your Grandchild

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Grandchild #2

First NameLast Name
Please Provide The Birth Date of your Grandchild #2

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Grandchild #3

First NameLast Name
Birth Date of Grandchild #3

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Your Grandchild #4

First NameLast Name
Birth Date of your Grandchild #4

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Your Grandchild #5

First NameLast Name
Birth Date of your Grandchild #5

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Your Grandchild #6

First NameLast Name
Birth Date of your Grandchild #6

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please list the name, age and birth date of each grandchild.
Please tell us your current situation and how your grandchildren came to live with you.
Annual Household Income
Household Size
Need Category
Description of Need

Please tell us how we can assist you today:
Children's Extracurricular activities (Must Include Flyer)
Children's Services
Children's Needs
If other assistance is required, please explain. (Because we are a small non-profit organization, we are unable to assist with rent, mortgage or utilities at this time.)

Below please upload the following 3 documents:

1. Driver License

2. Proof of All Household Income

3. Documents showing you are the guardian of your grandchild (Award letter, CPS forms)

Once we receive the information we will start the process. Our committee meets every Monday and will make calls on Tuesday. Please know it can take up to 5 business days. If you have any questions or concerns please feel free to contact us. WE CAN NOT PROCESS YOUR APPLICATION WITHOUT THE REQUESTED DOCUMENTATION.

Email all documents to

Info.grandlove@gmail.com
Signature
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upload a Copy of Driver's License

COPY OF DRIVER'S LICENSE
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Upload Proof of Monthly Income

Documents showing your monthly household income (Social Security award letter, pay stubs, pension statement, disability benefits, etc.).
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Upload Guardianship Documents

Documents showing you are the guardian of your grandchild (Award letter, cps forms)
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Activity Flyers! File Upload

Activity Flyers If Applicable
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Should be Empty:

Grand Love Application for Assistance