Evansville Police Department

Foundation

The Evansville Police Department Foundation exists

to award financial grants to the Evansville Police Department

for specialized equipment, education, collaborative community

programs, and for the support of its personnel.

Evansville Police Department Foundation

Family Emergency Fund Grant Request

The Evansville Police Foundation Family Emergency Fund was created to help employees in need. This fund was created for employees who are in financial need as a result of an emergency crisis situation such as a family member’s sudden illness, fire/flood damage to the primary home, unforeseen economic crisis, accident, death, or some other catastrophic event.

Grants are not loans and there is no expectation of re-payment. Requests are confidential and are limited to a maximum of $500.00* per request. Employees may only apply once in a twelve month period. Any employee may make a request on behalf of another employee in need.

*Additional funds may be granted at the discretion of the Board of Directors.

Application Process: Please fill out this form in its entirety and read carefully. If the question does not apply to you, N/A is the appropriate answer. After completing the application, please e-mail or deliver it to the Chair of the Programs Committee or a member of the Foundation Board. Completed applications may also be left in a sealed envelope addressed to EPDF Family Emergency Request, in the chief’s office. The application will be reviewed and notification will be made expeditiously.

Eligibility Rules: Grants are available to any full time Evansville Police Department employee in good standing with the Department. There must be an immediate and pressing financial need on the family that cannot be met through other means.

Criteria for Selection: The Evansville Police Foundation will base its decisions on availability of funds, priorities assigned to other requests and evaluation of the application.

Note: Please Type or Print answers. If more space is needed than that provided, please attach a one page letter explaining the nature of the need.

Recipient’s Information

Name: / Date:
Home Address/Telephone Number:
Name of Employee Making Request: Telephone Number:
Amount Requested: (Up to $500.00)
Request Summary (REQUIRED)
Write a brief summary stating the unexpected emergency situation for this request:
Check all boxes that apply to this request:
Fire/Damage to Primary Home
Personal illness/Injury
Family member illness/Injury/Death*
Other
*Relationship/Name of person who is ill:
Is the person covered by Health Insurance? Yes No

Disclaimer and Signature (REQUIRED)

The information I have provided on this application is true and complete. I authorize the EPDF committee to review this information for the purposed of granting funds.
Employee Signature: / Date:
For EPDF Approval Committee:
Date Received:______
Approved: Yes No Amount: ______

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