BGC Sponsor Form

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.^*

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)^*