Good Neighbor Fund Application

We are sorry to hear that you are experiencing hardship at this time. Thank you for trusting us to help!

The Upper Arlington Community Foundation’s Good Neighbor Fund (GNF) was established to help Upper Arlington residents who have a unique, unforeseen event happen in their lives that threatens their stability. The GNF is made possible by the Upper Arlington Community Foundation (UACF) and your Upper Arlington neighbors. Together, we work to ensure our neighbors in need know about this safety net.

This fund is specifically for one-time emergency assistance due to an event that seriously jeopardizes the recipient’s ability to meet basic needs. This fund serves as a last resort for those with urgent needs who have exhausted all other options for financial assistance.

Applicant Qualifications

You qualify to apply for a GNF grant up to $2,500 if you meet all of the following requirements:

An Upper Arlington, Ohio resident
Able to demonstrate financial need due to an unique unforeseen event such as illness, emergency event, or urgent circumstance that creates challenge
Applying for a GNF grant for the first time, and have not received a GNF grant in the past
Referred by one of our qualified Advocate Partners from the list below
Able to provide three references to confirm your financial need
Applying for a GNF grant after exhausting all other financial resources

Qualified Advocate Partners

The GNF is successful thanks to strong community relationships and our qualified Advocate Partners. The role of the Advocate Partner is to refer you to this program, confirm your need, assist you with this application process, and advocate on your behalf.

Advocate Partner

Please select which Advocate Partner is helping you and provide contact information.

Advocate Partner Contact Name

Advocate Partner Phone

References

List three personal/professional references and their phone number who can confirm your financial need.

These individuals will be contacted by the UACF staff.

Personal Information

Applicant’s Full Name

Phone

Street Address

City

ZIP

List people living in your household and their ages:

Have you requested emergency assistance from other sources before contacting the GNF?

Describe your emergency circumstances in detail, including dates:

Funding Request

Total Funding Amount

Enter the total funding amount of the invoices attached below. Creditors will be paid directly by the UACF.

I give permission to UACF staff to contact payee with any necessary questions regarding these invoices.

If selected for this grant, I am willing to share my personal story (anonymously or otherwise) to inspire others to support the Good Neighbor Fund.

Invoice 1

Invoice Description

Date of Invoice

Amount

Payment Method

Payment Due Date

Invoice 1

Attach PDF files only, up to 2 MB.

Invoice 2

Invoice Description

Date of Invoice

Amount

Payment Method

Payment Due Date

Invoice 2

Attach PDF files only, up to 2 MB.

Invoice 3

Invoice Description

Date of Invoice

Amount

Payment Method

Payment Due Date

Invoice 3

Attach PDF files only, up to 2 MB.

Invoice 4

Invoice Description

Date of Invoice

Amount

Payment Method

Payment Due Date

Invoice 4

Attach PDF files only, up to 2 MB.

Invoice 5

Invoice Description

Date of Invoice

Amount

Payment Method

Payment Due Date

Invoice 5

Attach PDF files only, up to 2 MB.

Validation

I certify that the above information is true to the best of my knowledge.

Your Full Name

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Good Neighbor Fund Application

Applicant Qualifications

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