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United Way Emergency Fund

This is an application to the United Way Emergency Fund. This is a once in a lifetime fund that provides Albertans in the United Way Northwest Region financial assistance in extraordinary circumstances not covered by other emergency funding.

The United Way Emergency Fund can provide funding in the following categories (including but not limited to): food and basic needs, medication, shelter, transportation, work equipment and utilities.

The United Way Northwest Region reaches communities from Grande Cache north to the Northwest Territories border and extends East from the BC border to Slave Lake and Fox Lake.

Completed forms will be reviewed for eligibility.

If you at any time are having problems completing the form, or need assistance with required documents please call our office at 780-567-2843

Please have the following documents ready to be uploaded to this application.

Proof of Residency (photo ID with your current address on it, or a bill with your address and name along with photo ID)
Proof of income - for all adults in household
Three months of bank statement- for all adults in household
Utility Bills with disconnection notices
Identification - for all adults in household
Documentation confirming assistance or denial from other funding sources.
Eviction Notice if applicable

You will be asked throughout this application to attach the required documents. If you do not have all the required documents, please select "Save" at the bottom of any page to save all other info related to your application so that you can access it later.

If you do not have all of the documents, please still submit your application and email any missing documents to nwfund@countygp.ab.ca

To qualify for United Way Emergancy Funds you must show financial need and you must first exhaust all other financial options in your community.

This can include but is not limited to: Alberta Supports, Housing First Programs and Foodbanks. Proof of this will be reguired to process your application.

If you have an eviction notice, or disconnection notice please apply to Alberta Supports before applying to the United Way Emergancy Fund:

https://www.alberta.ca/emergency-financial-assistance.aspx

Are you an Agency Representative filling out this application on behalf of someone?

Yes

First Name

Last Name

Date of Birth

What is the best way to contact you?

Phone

Phone Number

What is your email address?

How did you hear about this program?

Current Address

Town

Province

Postal Code

How many household members are there total?

Please list all members of the household, provide their full names, date of birth, and their relationship to you.

To add additional household members select the "add household member" button

Full Name

Date of Birth

Relationship

Identification (Required for every adult in the household)

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Protection of Privacy - Personal information is collected in accordance with Section 33(c) of the Alberta Freedom of Information and Protection of Privacy Act (the FOIP Act) and will be protected under Part 2 of that Act. It will be used for the purposes of administering the program or service for which the information is collected. Should you require further information about collection, use and disclosure of personal information, please contact the FOIP Coordinator at foip@countygp.ab.ca or call 780-532-9722.