Hardship Funding Application

You are completing hardship funding Application. These fields will automatically fill the Application File. You will be able to download you application at the end

Applicant’s Consent and Signature

First name:

Last name:

Address:

City:

Province:

Postal Code:

Preferred phone:

Alternate phone:

Local #:

Please state the amount of your request from the Hardship Fund $:

Reason for applying

Please give us a full and detailed explanation (or you can continue on a separate page if required.)

The Hardship Committee may contact you. Where necessary receipts, invoices or proof of need may be required. To the best of my knowledge, all the information given in this form is true.

Checklist before mailing or emailing application form:

Please ensure the application form is signed.

You have indicated your reason for applying.

You have ensured all your contact information is correct.

You have included all documents that support your application.

If mailing in the form, please mark your envelope Private and Confidential.

Applicant Signature

Clear

By signing this application, you give consent of your personal information to be discussed with all members of the Regional Hardship Committee.

Date

If you are human, leave this field blank.

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