LAR Members Helping Members Application

LAR Members Helping Members Application
Members Helping Members is a fund created through fund raising by its members. The purpose of the fund is to help LAR members who may find themself victim in a tragic event that causes financial hardship.

Purpose

To provide financial assistance to LAR members, or their immediate families (defined by Labor Code Section 2066) who may find themselves in need of assistance caused by an unforeseen medical emergency, accident, death, long-term or terminal medical diagnosis, physical disability or catastrophic event that causes misfortune.

Qualifications and Criteria for assistance
- Applicant or Advocate must be a member of Lodi Association of Realtors for at least 1 year and in good standing.
- Applicant or Advocate must provide specific need for assistance by submitting a completed application.
- Applicant or Advocate must indicate how LAR can facilitate that need. Applicant or Advocate agrees to be contacted by Henrietta Van Dyk, Terri Lopes or Ryan Anson from LAR if additional information is needed.
All information will remain confidential unless otherwise noted by applicant or advocate.
ApplicantAdvocate (person representing Applicant)
1. What is the hardship that led to this request? Please be detailed as possible.
2. Please provide a description of the intended use of funds
Applicant
Applicant Name
DRE#
Phone #
Format: (000) 000-0000.
Email address
example@example.com
Mailing Address
Advocate
Advocate Name
Advocate Phone
Format: (000) 000-0000.
Email
Applicant or Advocate Signature
Date

MonthDayYear
Advocate Signature
Date

MonthDayYear
Should be Empty:

LAR Members Helping Members Application

Purpose

Qualifications and Criteria for assistance

Applicant

Advocate