Employee request for support through the United Charities Fund

Before applying, please review the United Charities Employee Hardship Grant Policy outlining the guidelines and procedures to provide financial assistance to any employee facing significant financial hardship.

United Charities Hardship Grant Policy

Fields marked with are required.

I am completing this application on behlf of:

Myself

A Direct Report

First Name

Last Name

Address

City

State

Zip Code

Rent or Own

Number of People Living in Household

Phone

Current UPMC Hamot Department

Supervisor Name

Please Explain the Nature of Your Hardship

Have you applied for the UPMC financial hardship program?

Yes

Are you experiencing food insecurity?

Yes

Are you currently or are you at risk for homelessness?

Yes

Employee request for support through the United Charities Fund

Employee Giving