arrowheadunitedway.oneeach.org

Assistance Request Form

Arrowhead United Way Has Established an Emergency Relief Fund to Support those in the Arrowhead United Way Service Area Who are Most Vulnerable during the COVID-19 crisis. This fund will help support: low-income individuals and families at imminent risk of homelessness; the current IE population experiencing homelessness; low-income students; and our partner non-profits.

Funding for direct assistance will be available BASED ON CONTRIBUTIONS RECEIVED. United Way is not able to guarantee funding beyond what is received in this fundraising effort.

To make a donation to the San Bernardino United CIVID-19 Relief Fund, please click here.

To request assistance, please fill out the form below.

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First Name *

Last Name *

Address *

City *

Zip code *

Phone *

Email *

Age of applicant *

18-30

31-54

55-70

71+

Please describe *

Select all that apply

Veteran

SSI Reciepent

SNAP Reciepient

Number of people in the household? *

Anyone in the household under the age of 18? *

Yes

How many under the age of 18? *

Tell us your story *

Please describe how the COVID-19 pandemic has affected you. Feel free to share whatever you think will be important for us to know about your situation.

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Assistance Request Form