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Employee Emergency Fund Application Form

As of Jan. 1, 2021, the criteria has changed to be considered for COVID-19 Employee Emergency Fund assistance.

We ask that you please remain patient as the approval process may take two to three weeks after the application is submitted.

Please note: Only one member of the same household may apply for assistance.

 
I am requesting financial assistance for the following expenses as a result of being impacted by the COVID-19 Virus (check all that apply)
Submit the following: Current or past due mortgage statement or current or past due rental agreement.
Submit a current or past due copy of your bill.
Submit the following: A statement from the daycare or elder-care provider indicating the amount currently due, and any special COVID-19 payment arrangements made by the provider. The day-care center or child-care provider’s tax ID number.

Please email all supporting documents to lstaggs@srhs.com with the subject line "COVID-19 Employee Emergency Fund Application Supporting Documents". Supporting documents should be submitted within 24 hours of submitting this application. Applications must be completed in its entirety and will not be considered unless supporting documents have been submitted.

Your request for financial assistance will be held in the strictest of confidence by the Administrator of the Spartanburg Regional Foundation COVID-19 Employee Emergency Fund. Human Resources may be consulted to confirm your working hours, unemployment received, or furlough pay received and other information needed by the committee.