Arizona Restaurant Association Foundation Relief Fund

Arizona Restaurant Association Foundation Relief Fund
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reason for applying*
Must be due to COVID-19 restrictions
Please describe details of hardship*
Place (Name) of primary employment*
Position held*
How long employed at primary establishment?*
Supervisor's name*
Supervisor's contact info: phone &/or email*
Do you have any ownership/partnership at this establshment?

YesNo
Are you currently receiving any form of compensation from a liquor licensed establishment?*

YesNo
Do you have a second source of income?*

YesNo
Place of secondary employment
Position held
How long employed at secondary establishment?
Supervisor's name
Supervisor's contact info: phone &/or email
Please upload two (2) paystubs from your primary employer. One needs to reflect a pay period during 2/29/20 or after. And at least one needs to reflect full time status (30+ hrs/wk). Make sure the files you upload are not password protected*

Browse Files
pdf or jpg format required Cancelof
Please upload your two (2) most recent paystubs from secondary employer (if applicable) Make sure the files you upload are not password protected

Browse Files
pdf or jpg format required Cancelof
Please upload official confirmation of unemployment filing with your full name on it along with address. Make sure the file(s) you upload are not password protected*

Browse Files

Cancelof
Date*

MonthDayYear
Date
Time*

:HourMinutesAM/PM Option
If approved, funds will be dispersed via PayPal or Company check. Please indicate the preferred method of payment:*

PayPalCompany Check
If you selected PayPal, please let us know the phone number, email, etc. that is associated with your PayPal account.
Signature
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