Helping Hands

The SIA Helping Hands Fund offers assistance to Southport residents experiencing extraordinary financial hardships related, but not limited, to job loss, medical bills, family disruption, or an unexpected calamity that negatively impacts economic stability

Application

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

I am:

What is your immmediate need?

List unusual expenses that put you over the edge:

Have you previously received assistance from:

Town Office

Local/State/Federal Agency

Local Church

What kind of assistance did you receive?

I am currently employed:

Total monthly Household Income

List all sources (aid, employment, disability, child support)

$

Assistance Requested:

(List the type of assistance and amount being requested)

$

Would you be willing to work with someone on budget planning?

Any Additional Comments/Information:

Helping Hands

Helping Hands

Application

CONTACT

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