Emergency Request Form

In order to request emergency funding from UWCNM, please fill out the form below. An emergency is defined as an event which threatens an organization’s ability to deliver core services. Only agencies currently receiving a United Way of Central New Mexico Community Fund grant may apply for an Emergency Grant. An agency may request up to $10,000 per year. Submit the completed form. For capital requests, please fax two bids to 242-3576 Attn: Randy Woodcock.

 

To apply electronically, please complete and submit the form below.

 

The request will be reviewed by the Community Services Group. The funding recommendation of the Community Services Group will be communicated electronically to the organization's Executive Director and Board President.

Thank you!

 

*Organization Name:
*Contact Person:
*Contact's Phone Number:
Contact's email Address:
*Amount of request:

 

*Describe the emergency and the organization's inability to foresee this occurrence:

 

Describe how needed services will be interrupted:

 

Outline how the emergency funds will be used:

 

Are there other possible sources of funding to help handle this emergency?

 

How does this emergency put your UWCNM funded program at risk?