COVID-19 Impact Fund Application

The purpose of the COVID-19 impact fund is to make one-time, temporary, flexible resources available to families to resolve financial challenges associated with COVID-19.  The CCC is using the Hope Fund as the structure to administer these funds inviting CCC partner agencies to apply on behalf of their clients.  The Hope Fund committee will be the review committee for COVID-19 impact funds. Applications need to be submitted by staff providers and all communication is between the provider and the committee.

  • General Information

  • COVID-19 impact funds are available to families with children pre-natal through 18 years.
    Child 1Child 2Child 3 
  • Request/Need Information

  • How has the family been impacted financially?
  • Please describe the request. What would funding help resolve?
  • What are the consequences for the family if this request is denied?
  • The review committee has discretion to reject, partially fund, or fully fund requests.
  • Required Documentation

    All requests must include formal, specific documentation of the need that equals the total requested amount. Acceptable documentation could include invoice or estimate for repair, purchase, or services; notice from a landlord; or provider statement of need (such as food and supplies).
  • Tips for uploading documents

    If your client needs to submit a photo of a bill as part of the family's application, ask them to use the flash when taking the photo, and to email you the photo (large size is best) instead of texting you, if possible. Emailed photos are much clearer than texted photos which can be very hard to read.
  • For assistance with required documents, please text or email Angela Donaghy at 207-263-5647/
    Drop files here or
    Accepted file types: jpg, pdf, doc, png, xls, docx, Max. file size: 8 MB.
    • Payment Information

    • (landlord, mechanic, company name, etc.)
    • A multi-agency committee of the Community Caring Collaborative reviews applicant information. The CCC encourages providers to arrange for necessary releases of information.
    • Please print your name - this will be your e-signature
    • MM slash DD slash YYYY
    • This field is for validation purposes and should be left unchanged.