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About
Our Mission And History
What Is United Way?
Our Leadership
Our Reports
Donate
Room Reservations
Local Programs
2020 Supported Agencies
Agency Grant Application
Get Involved
Donate
Volunteer
Day of Caring
Verna K. Hall Leadership Society
Partner Companies
Get Help
2-1-1 East Texas
Community Programs
East TX Center for Nonprofits
ETCN Membership
Current Members
Members Only Page
Personalized Services
ETCN Trainings
Management Certificate
Advanced Certificate
Nonprofit Job Opportunities
Get Connected East TX
ETCN Contact Us
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Sponsor Acknowledgement Form:
This form is required to pre-qualify a Partner who is seeking assistance. Once you submit, the Grant Administrator will send information on next steps and accessing the online grant.
RM_Stats
Sponsor's Name
*
Title
*
Sponsor's BGC Partner ID #
*
Email
*
Phone Number
*
Partner's Name You Would Like to Sponsor
*
Partner's ID #
*
Partner's Best Contact Number
*
Partner's PERSONAL Email
*
Store #/Dept.
*
Please Check Appropriate Person in Need
*
Partner
Partner's Spouse
Partner's Minor Child
Partner's Legal Dependent
Please Check Appropriate Event or Crisis
*
Serious Injury (Requiring Hospitalization)
Serious Illness (Requiring Hospitalization)
Death
Natural Disaster (includes hurricane, tornado, flood, ice/wind storm)
House Fire
Does this situation qualify for an urgent need request? If yes, the partner may receive up to $1,000 within two business days of submitting the application while total request is being reviewed and considered. In order to receive immediate funds for an emergency situation, we must get the partner's banking details and good contact information. (Applicable in situations like a house fire where the partner has lost everything and needs immediate assistance). ANY IMMEDIATELY RELEASED FUNDS WILL BE CONSIDERED PART OF THE TOTAL GRANT AMOUNT THAT IS APPROVED LATER.
*
Yes
No
If yes, what amount are you requesting? (NOT TOTAL GRANT AMOUNT. JUST AMOUNT UP TO $1,000 FOR IMMEDIATE RELEASE.)
Partner's Bank Name
Routing Number (9 Digits that appear on bottom of check)
Account Number
Other Comments Describing this Situation (Limit 500 characters)
*
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