United at Work Fund

United at Work Eligibility Criteria:

Must have exhausted all other community resources.
Employed in Charlotte County
Must have been directly and significantly affected by a disaster, such as hurricane, flood, or fire.
Demonstrate substantial financial impact from the disaster that affects their ability to maintain stability. Examples include prolonged income loss, housing instability, or essential expenses that cannot be met. (documentation required)

After you complete the form below, you will be contacted by a case worker who will work to connect you with essential resources and funds, as appropriate.

We ask that you please be patient and only submit one application per qualified disaster.

Case workers are assigned to cases based on the urgency of the crisis and not on a first-come-first-serve basis.

How were you referred to United Way Charlotte County?

Have you applied for United at Work assistance previously?

Yes

Do you work for an employer that is based in/has sites in Charlotte County?

Yes

United at Work is a fund created to support the Charlotte County workforce. For individuals who are employed outside of Charlotte County, please reach out to your local United Way or United Way of Florida.

Is this hurricane/disaster related?

Yes

FEMA/Disaster documentation

Upload requirements

United at Work Form

Head of Household

Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Date of Birth

Employer

Additional household members

Total number of adults in the home (including yourself)

Total number of children in the home

TOTAL IN HOUSEHOLD 0

Adult #2

Name (first & last)

Date of Birth

Employer

Adult #3

Name (first & last)

Date of Birth

Employer

Child #1

Name (first & last)

Date of Birth

Child #2

Name (first & last)

Date of Birth

Child #3

Name (first & last)

Date of Birth

Child #4

Name (first & last)

Date of Birth

Child #5

Name (first & last)

Date of Birth

Child #6

Name (first & last)

Date of Birth

Request for Assistance

Briefly describe your need for assistance?

What type of assistance do you need? (check all that apply)

housing (displaced, 1st/Last rent)

mortgage (My normal mortgage payment.)

rent (My normal rent payment.)

utilities (electric, gas, water)

food and/or water

transportation needs (work/school related)

Other…

Documents

Photo ID

Upload requirements

Pay stubs (last 2)

Upload requirements

By clicking submit, I acknowledge that:

All information I have provided above is truthful and accurate;
I may be required to submit supporting documents as necessary;
All information provided will be verified and kept in a confidential database.

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