Jotform Responses- Wycliffe Cares-Wycliffe Golf & Country Club Employee Assistance Grant Program

WYCLIFFE CARES GRANT APPLICATION

STEPS TO TAKE BEFORE APPLYING

STEP 1: Read Grant Program Overview and Review FAQs

Wycliffe Golf & Country Club has partnered with The Community Impact Fund (CIF) to offer Wycliffe Cares, an employee assistance grant program. The program operates slightly differently than the former grant program and has specific eligibility requirements as well as clear guidelines on what situations qualify for a grant request and which do not. Therefore, it is important to review the program overview prior to applying.

Click here to review the Grant Program Criteria and click here to review overall program F.A.Q.s

STEP 2: Prepare your Required Documents

As part of your grant application you will be required to upload a pdf or photo of two documents for you and your spouse/partner, if applicable: 1) your W-2 for purposes of verifying your identity, employment and income, and 2) a document demonstrating your requested need such as a medical bill, invoice, or estimate for a vehicle/home repair, and 3) your two recent paystubs.

Note: You can request up to $5000 for a requested need but your documentation must demonstrate that amount of need. You can only make one request per rolling calendar year and can only request support for one need. For example, you cannot upload two documents such as a medical bill for $3000 and a car repair for $2000 and request $5000.

STEP 3. Download the Zelle app in preparation for receiving your grant

While not every grant request will qualify to be approved, it is important that you are set up in Zelle to receive your grant should you be approved.

Grant funds will be disbursed through Zelle, a mobile money app that you download on your mobile device. It is available for both iphone and Andriod.

If you would prefer to receive a check instead, please check the box in your application and confirm your mailing address. Checks can take up to 7 business days to receive after your application had been approved.

Ok! Once you have completed these three steps you are ready to complete you application!

If you have questions about your grant application or the grant program, first review the F.A.Q. tab on this site or contact the Community Impact Fund grant administration team at loans@communityimpactfund.org.

Full Legal Name

First NameLast Name

Preferred name or name that you use if different than your legal name

First NameLast Name

Personal Email

example@example.com

Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

What is your physical address?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your mailing address?

Street Address

Apartment number

CityState / Province

Postal / Zip Code

Are you an employee of Wycliffe Golf & Country Club who has been employed for at least six consecutive months? (Required to be eligible for a grant.)

Do you file single or married filing jointly on your tax return?

If you are married and file jointly, what is the name of your spouse? If you file as single, type: N/A.

How many dependents reside in your household/ claim on your taxes, not including your spouse.” How many dependents reside in your household/ claim on your taxes, not including your spouse.”

What is your estimated total household income before taxes? This is the amount of income that is listed on Line 9 of your 1040 tax form. If you don't have that accessible please do your best to estimate based on the description below.

This is the total annual income of each individual reported on your taxes if married filing jointly. If you file as an individual (single) on your taxes, type your total annual income.

What are your estimated total monthly expenses?

This includes payments due for rent/mortgage, utilities, and other expenses such as food, healthcare, etc.

What is your estimated total balance of debt?

The actual or estimated TOTAL due of all of your outstanding debts including medical, auto loans, student loans and credit card debt.

What is your estimated total balance of your savings account?

Please select the category of need which is most closely aligned with your need.

Max amount that can be applied for under Basic Needs (Food and Clothing) for each individual or couple - plus dependents claimed on taxes. (Example: Applicant + Spouse + 2 Dependents = 4 Persons $1375)

How much are you applying for? *Read the description below.

$5000 is the maximum request that can be made, unless your request has additional limitations, such as an auto repair or Basic Needs. Refer to page 2 of the grant criteria document linked in the intro and FAQs to qualify your request. Please note that you must upload proof of need that is equal to the amount that you are requesting. If the amount is greater than $5000, then you can only request $5000. You cannot request a grant for multiple needs totaling $5000.

Needs Statement: Please describe why you need this grant. (Must match category selected above and Documentation provided)

Document Upload: Proof of Identity, Employment & Income. Please upload a picture or file of your most recent 1040 tax form. If you don't have your 1040 on hand, please upload all W2s or recent pay stubs (within 30 days) for your household including that of your spouse/partner if you are married and file jointly. Note the accepted file formats below.

Accepted file formats pdf, doc, docx, jpg, jpeg. If you have trouble uploading, please contact loans@communityimpactfund.org.

Document upload to demonstrate proof of need. Please upload a picture or file that demonstrates the proof of need which you described above in your needs statement. You can only upload one document for one specific need. This can be a picture of a medical bill, an estimate for an emergency vehicle/home repair, an overdue utility, a rent/mortgage bill, or a receipt for funeral expenses. PLEASE NOTE: Anything you upload must be in your name or your name or your spouse's name if you file jointly. The address must match the ones you provided above.

Accepted file formats pdf, doc, docx, jpg, jpeg. If you have trouble uploading, please contact loans@communityimpactfund.org.

If your application is approved, how would you like to receive your funds?

If you select Zelle, you need to have your Zelle app set up and be able to provide your account information. If you opt to receive a check, it will be sent to the mailing address you provided above. Note: It can take up to 7 business days to receive a check.

If you want to receive your grant funds through Zelle, what is the first and last name, email, and phone number that you used to set up your account? If you are receiving a check, please type the word: CHECK.

I certify that the information in this application is true and accurate to the best of my knowledge. I also certify that the need described in this application is causing a financial hardship. If my application is approved, I will use the grant funds to address this specific need.

Wycliffe Cares Grant Application