FAX COVER PAGE

GRANT APPLICATION & REQUIRED DOCUMENTATION

To: Grant Review Team From:

Fax: +1.561.868.2189 # Pages:
Phone: +1.855.931.4248 Date:

Documentation of your event and expenses must be provided before your application can
be considered. Please provide your contact information:

 Email: _____________________________________________________________________________

 Phone #: ______________________________________________________________________

Enter details below to describe your supporting documentation.

EVENT DOCUMENTATION: See next page.

EXPENSE DOCUMENTATION: (Write in your expenses.)

1. _____________________________________________________________________________________

2. _____________________________________________________________________________________

3. _____________________________________________________________________________________

4. _____________________________________________________________________________________

5. _____________________________________________________________________________________

OTHER (Describe): _________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

emergencyassistancefdn.org @eafrelief
Updated 03.22.2022
 Check the box for your
event
EVENT AND SUPPORTING DOCUMENTS REQUIRED
☐ Government (nation/state) declared disaster, or determined the event was catastrophic
☐ Presidentially declared disaster (USA)
Examples of News report, statement from a government official, insurance report, emergency responder
documentation: report, photographs of damages.
☐ Details showing how you/your eligible
Documentation must ☐ Event ☐ Event ☐ Event
dependent/your property were affected by
include: date description location
event
☐ Epidemic
Examples of Official notification of quarantine/significantly reduced hours/school, daycare, business closure,
documentation: or a doctor's note confirming illness.
Documentation must Proof that you/your eligible dependent were impacted by the epidemic (unable to work,
include: quarantined, unexpected childcare, seriously ill).

emergencyassistancefdn.org @eafrelief
Updated 03.22.2022