2020 DISASTER RELIEF GRANT APPLICATION

The 2020 hurricane season is expected to be a strong one, and the Coast Guard Foundation and Coast Guard Chief Petty Officers Association work together to provide disaster relief assistance to Coast Guard members who have been impacted.

When natural disasters strike, the Coast Guard Foundation and the Chief Petty Officers Association are here for you. Coast Guard members are often first responders—leaving their own impacted homes and property to aid others. We assess member and family needs through our disaster relief and response program and make sure you get resources to bounce back from hurricanes, floods, tornadoes, and more.

Coast Guard members are eligible for a grant up to $3,000 to cover personal loss and basic needs after a storm strikes. These needs include, replacement and repair of household goods, food and basic necessities, insurance deductibles, temporary housing, and emergency travel.

You may complete the application online here or download a PDF of the application and submit it to executivedirector@uscgcpoa.org for review.

The CPOA will review and respond to your application within five days of receipt. You may email executivedirector@uscgcpoa.org or call (703) 941-0395 with any questions.

For more information on the Coast Guard Foundation's disaster relief program, visit coastguardfoundation.org/relief

Name: *

Prefix First Name Last Name Suffix

Address: *

Street Address

Apt. #

City State / Province

Postal / Zip Code

Mailing Address Type: *

Home Duty Station

Can we mail a grant check to this address? *

Yes No

Work E-Mail: *

example@example.com

Personal E-Mail:

example@example.com

Preferred Phone Number: *

Area Code Phone Number

Alternate/Cell Phone: *

Area Code Phone Number

Status of Applicant: *

Active Duty Reserve Retired Civilian

Rank/Rate: *

E-7,0-3, for example

Current Coast Guard Unit: *

Name of cutter, unit, station, etc.

Does the applicant have a spouse? *

Yes No

Does the applicant have children? *

Yes No

If yes, please indicate the number of dependent children listed in DEERS.

Name of Storm/Natural Disaster *

Hurricane Laura, California Wildfire, for example

Amount of Grant Request: *

(Up to $3,000)

How will you use the grant? *

Has the applicant received a grant from other sources? *

Yes No

If yes, please provide the name of the grant source and the amount received.

Does the applicant have insurance? *

No Yes, flood insurance Yes, homeowners insurance Yes, renter's insurance

Has the applicant received or expecting to receive, insurance funds to cover losses? *

Yes No

If yes, please provide the insurance provider name and the amount received/expected.

Please attach documentation here.

Browse Files

Receipts, estimates, photos of damage

Please use this space to detail any additional information re: your grant application.

By signing this application requesting a grant from the Coast Guard Foundation & Coast Guard Chief Petty Officers Association, I hereby declare that the information contained in this application is accurate to the best of my knowledge, and understand that any misstatement of fact may be grounds for denial of this request.

I expressly waive and hold harmless the Coast Guard Foundation and Coast Guard Chief Petty Officers Association and any Coast Guard representative who may be acting on behalf of this Fund, from any and all claims that might arise as a result of this application.

I understand that the Coast Guard Foundation and Coast Guard Chief Petty Officers Association is an independent private entity, not part of the U.S. Government. This application form, therefore, is not subject to the Privacy Act (5 U.S.C. 552a). This form, with attachments, will be kept on file for a period of five (5) years.

I understand that this Fund exists to help meet the basic needs of those impacted by 2020 Disasters. Those needs include but are not limited to:

a. Housing/Lodging
b. Homeowner’s / Renter’s Insurance Deductibles
c. Food
d. Emergency Travel

I understand that grants will not be considered for (and are not limited to) the following:

a. Credit card expenses
b. Legal expenses
c. Business debts
d. Late fees or irresponsible financial acts
e. School expenses

I have read, understand and agree to the above requirements for receipt of a monetary grant from the Coast Guard Foundation and Coast Guard Chief Petty Officers Association.

Signature

Clear

Date