Union Hardship Assistance Application Form
Provide your details, hardship information, and requested assistance amount, then review and sign your declaration.
Applicant name
*
First Name
Last Name
Membership ID
*
Union local
*
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Type of hardship
*
Please Select
Medical or health-related
Housing or utility emergency
Job loss or loss of income
Natural disaster or property damage
Family emergency
Other
Describe the hardship and its financial impact
*
Amount of assistance requested
*
Upload supporting documentation, if required
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Applicant signature
*
Submission date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Application
Submit Application
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