Apalachee High School Victims' Fund
This form should be completed by the legal heir, parent, or guardian of those killed or wounded by gunfire in the mass shooting that occurred on September 4, 2024 in Winder, GA. Once the fund closes and the applicant has been verified, all payments will be made by check and sent via USPS.
Your Name (Legal Heir, Parent, or Guardian)
*
First Name
Last Name
Your Email
*
example@example.com
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Your Photo ID (To Verify Your Identity)
*
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What is your relationship to the victim/survivor?
*
Please Select
Parent/Legal Guardian
Spouse (Legally Married at Time of Death)
Marriage Certificate (if married to murdered victim)
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Do you currently receive any income-based public benefits or government assistance (ie, Medicaid, SNAP, etc.)?
Yes
No
Name of Victim/Survivor
*
First Name
Last Name
Birthdate of Victim/Survivor
*
-
Month
-
Day
Year
Date
Does the victim/survivor have a will, trust, or custodial account?
*
Yes, a will
Yes, a trust
Yes, a custodial account
No, there is no will, trust, or custodial account
If there is a will, upload here.
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Submit
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