Washington County Hardship & Disaster Relief Program Application

By Referral ONLY

Apply for Hardship & Disaster Relief

Processing time: 7-14 days

Applications are accepted year-round and evaluated every 1-2 weeks. Delays occasionally occur, but can usually be avoided by submitting as much detailed and accurate information as possible.

Name of Applicant:

First Name

Last Name

Home Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

County of Residence:

Members of Household:

Please list all individuals living in the household, including their name, age, and relationship to the applicant. EXAMPLE: John Smith, 38, Husband Jane Smith, 7, Daughter Judith Doe, 70, Mother

Referring Organization Name:

Name

Referral Contact Name:

First Name

Last Name

Referral Contact Email:

Referral Contact Phone:

(###)

###

####

Amount Requested:

Please specify the amount being requested. The amount must be verified by the referring organization and/or supported with documentation such as a statement, invoice, or quote showing the total cost or balance due.

Description of Need:

Please describe the circumstances that have created the hardship and how the requested assistance will help address or improve the situation. The need must be verified by the referring organization. Supporting documentation is appreciated, if available. (EXAMPLE: Applicant experienced an unexpected medical emergency that temporarily prevented them from working. The referring organization has verified the need and confirms that the requested funds will help cover an immediate housing or utility need to stabilize the situation.)

Funding Coordination

Can your organization accept grant funding directly from Marietta Community Foundation to ensure payment is made to the appropriate party?

Yes

Unsure

Next Steps

Submit Application and Documentation
- Complete the application on behalf of the client or family you are working with.
- Documentation of the need is appreciated and may be necessary to confirm the amount needed. Please attach any supporting documentation to the application, such as:
  - Documentation of the expense (e.g., invoices, statements, eviction or shut-off notices).
  - Documentation of the event causing financial hardship (if applicable).
Wait for a response
- We will contact you via email on the status of your application.
- Please note that processing may take up to 1-2 weeks.
- To speed up the process, ensure that you provide specific details about the hardship, what is needed, and the cost of each expense needed.
Email us about any changes/updates
- If any information changes after submitting the application, email hardship@mcfohio.org as soon as possible to make sure the Committee is aware, especially if the request is no longer needed or if the cost of the expense has increased.

Washington County Hardship & Disaster Relief Program Application

By Referral ONLY

Apply for Hardship & Disaster Relief

Processing time: 7-14 days

Your request has been received. Please note that processing may take 1-2 weeks. If you have any questions regarding your application or need further assistance, please contact our Hardship Line at (740) 315-8510.

In the meantime, continue scrolling to the bottom for the next steps while you await a response about your application.

Next Steps

Submit Application and Documentation

Wait for a response

Email us about any changes/updates

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