ALICE Funding Application

ALICE Funding Application

Please fill out and submit the following form
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you involved in a Goodwill Program?
1. What financial need or unexpected expense are you requesting ALICE assistance for? Please explain what you need help with and how it is affecting your ability to maintain employment or financial stability. *Provide documentation of need below
Please attach documentation of the need with this application.

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2. What resources have you explored to help with this expense? Please include any community resources, agencies, employer assistance, family support, payment plans, or other resources you have contacted or used.
3. How would this assistance help you maintain employment or improve your financial stability? Please explain how receiving this assistance would help you move forward and what your plan is for managing this expense or avoiding the same barrier in the future.
Client Acknowledgment

By submitting this application, I understand that:

· ALICE funding is limited and assistance is not guaranteed.

· I must be an active Goodwill client and at least 18 years old.

· I will work with my Case Manager to create a realistic budget and plan.

· I may be asked to provide additional documentation.

· ALICE assistance is limited to one time per person, unless additional approval is provided.

· If approved for funding, I am required to complete a financial-related Goodwill Academy course.

· The amount of assistance will be determined based on my documented need, available resources, my contribution, and the overall plan.
Client signature
Should be Empty: