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Hospitality Workers Hardship Fund Application
You will be contacted when we receive your application.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where did you hear about us?
*
Community/Union leader
Worker Power website
Friend
Other
If you selected Community/Union leader, please list their name. Type N/A if you selected other choices.
*
Are you currently employed?
YES
NO
Employer name
*
Please describe the reason you are applying for hardship assistance
*
Submit Form
Should be Empty: