Community Cares Application Request Form

Community Cares is a program funded by our staff and community to assist members with unexpected financial burdens of basic needs. Basic needs are the essential material requirements to support wellbeing, including (but not limited to) adequate food, shelter, clothing, hygiene and medical, psychological, optical, and dental care.

If you know someone or are someone who may benefit from the Community Cares program, please submit the online request, along with necessary documentation.

If you would like to contribute to our Community Cares Grant, funds can be deposited via our Venmo Account. Further donation options are available at any of our branch locations.

Venmo Account: @ComFirstFCU

First/Last Name *

Member Number *

Please select the best form of contact: *

Email

Phone Call

Text

Contact information in relation to previous question: *

Please check which basic need/unexpected financial burden you need assistance with:

Food

Shelter

Clothing

Hygiene/Medical

Psychological

Optical/Dental

Transportation

Death/Funeral

Requested dollar amount (Limit $250) *

Please explain the reasoning for the request: *

Please explain why the reasoning is unexpected: *

Can you provide proof of the need, bill, or financial burden? *

Yes

No

Please attach documentation of proof (example: receipt or bill):

Click or drag & drop file here to upload

Submit