Screening Form for the Excluded Worker Fund | Columbia County Sanctuary Movement CRM

Screening Form for the Excluded Worker Fund

This is a screening tool and NOT an application. We are encouraging people to still fill out this form so we can work on ensuring you have the proper documentation to be able to apply if the fund opens again, as well as support anyone in the appeals process.

 
 
 
 
Were you eligible for or did you receive any of the following benefits or income relief during the pandemic?
 
Were you eligible for or did you receive any of the following benefits or income relief during the pandemic?
 
 
 
 
Be sure to scroll to view all options. Must have a total of 4 points for Proof of Identity. Any documents that are not in English must be accompanied by a certified English language translation (applicants can self-certify translations).
Be sure to scroll to view all options. See next question for additional options. Must have either one document from this section or two from the next for Proof of Residency.
Be sure to scroll to view all options.
Be sure to scroll to view all options. Must have a total of 5 points for Tier 1 or 3 points for Tier 2 for Proof of Work History.
 
 
 
 

This is a screening tool and NOT an application. We are encouraging people to still fill out this form so we can work on ensuring you have the proper documentation to be able to apply if the fund opens again, as well as support anyone in the appeals process.

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