COVID-19 Individual Family Grant

United Way of the Brown County Area and Brown County Chambers COVID-19 Individual and Family EMERGENCY Assistance Fund

United Way of the Brown County Area in partnership with Brown County Area Chamber offices created a special grant opportunity to help individuals and/or families experiencing a financial difficulty as a direct result of COVID-19. Please read the eligibility requirements carefully to see if you may qualify for assistance.

Eligibility & Requirements

To be eligible, an applicant must meet all of the following:

Reside in Brown County. Provide picture ID and proof of a current Brown County Address.
One adult member of the application household must have been employed in an industry that have been impacted by MN Executive Order 20-99. Bar, restaurant, spa, pool, theater, gym, lodging, event or convention center, or any other service or public accommodation.
Applicant must be without resources to meet the emergency need due to COVID-19. For example, proof of being laid off or hours reduced due to the MN Executive order 20-99 or COVID-19 illness.
Applicant must provide a written eviction notice, overdue rental, mortgage, daycare, utility, heating fuel, or other notice of past due water/sewer bill payment.
Once completed all monies approved will be vendor paid when possible. In some instances, the committee has the discretion to pay funds directly to the applicant.

Application Process

To be eligible, an applicant must meet all of the following:

Completed COVID-19 application
Picture ID
Proof of residence in Brown County Minnesota
Proof of emergency need (overude bill or other notice)
Applications will be reviewed each Friday following the opening of applications on December 21st, with committee approving applications by the following Monday and checks issued by the following Wednesday.

*Please have these documents ready to upload before you begin.

All applicants are required to have or create an account to complete and submit your application. Keep your user name and password handy so that you can "save a draft" and return to complete your submission. Also, this user name and password will continue to be used for agency reporting and future applications.

LOGIN HERE (If you already have a user name and password)
CREATE AN ACCOUNT (New users only - an email will be sent to you)
RESET YOUR PASSWORD (If your email has been used previously, you can reset your password)
LOGOUT (Be sure to log out once you have saved your draft or submitted your application)

Incomplete applications will not be accepted. Do not leave any blanks; enter N/A if not applicable.

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Household Information

First Name *

Last Name *

Street Address *

Phone Number *

Email Address *

City, State & Zip Code *

Number of household members *

List names & age of household members: *

Please select the following type of establishment you (or a family member) were laid off from, or hours reduced, prior to the recent MN Executive Order 20-99: *

Other Establishment *

Emergency Request:

Emergency Request Date *

Month

Day

Year

Emergency Request for: *

Other Request (Please be specific) *

(Please explain the Emergency assistance you need and how it relates to the COVID-19 Pandemic.)

Emergency amount needed to cover all above: * $

Business or Bill Owed To: *

Business or Bill Contact Phone Number: *

Total Amount of COVID-19 assistance Funds Requested: *

Documentation

Upload Photocopy of Picture ID *

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png tif pdf doc docx xls xlsx.

Upload Proof of Brown County Residency (This can be a utility bill or other bill with your name and address on it.) *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png tif pdf doc docx.

Upload business or other bill showing what is owed (Rental, Utility, Medical, Daycare, etc.) *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png tif pdf doc docx.

CERTIFICATION *

I certify that the above information is accurate.

Form Preparation Information

Form Prepared By (First and Last Name) *

Today's Date *

Month

Day

Year

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