ARH Employee Emergency Assistance Application

Funds will be awarded for expenses incurred starting April 1st.

IMPORTANT: PLEASE EMAIL, FAX OR SNAIL MAIL ALL SUPPORTING DOCUMENTATION TO ONE OF ADDRESSES OR THE FAX NUMBER LISTED ON THE CONFIRMATION PAGE AFTER SUBMITTING THIS FORM.

 
 
 
 
 
 

Address

 
 
 
 

If you are not receiving unemployment, please explain.

Is your spouse/partner working or furloughed? If furloughed, is he/she receiving unemployment benefits?

 
 

Please explain your situation in detail.