Sun Prairie Disaster Relief Fund
Application for Financial Assistance
Due Date: Friday, August 17th 5:00pm
Thanks to the generosity of our community, there are funds available to help Sun Prairie residents and businesses affected by the July 10th downtown explosion. Impacted residents, business owners/operators, and individuals who worked within a half mile of North Bristol and Main Street may be eligible for a distribution from the fund.
This is the first round of several anticipated application processes to request financial assistance from the Sun Prairie Disaster Fund to help with recovery from unanticipated losses caused by the July 10th event. Other funding opportunities will be determined as resources allow.
- Business owners/operators or employees who worked in the impact zone should directly contact United Way of Dane County for assistance.
- Impacted residents who live within a half mile of North Bristol and Main Street should use this form to request assistance. Funds may be used for:
- Insurance deductible reimbursement
- Anything not covered by insurance
PLEASE LIST ALL FAMILY MEMBERS & THEIR AGES
Please check all boxes that you would benefit from as a result of your loss from the incident:
CONSENT FOR RELEASE OF INFORMATION
IMPORTANT: By clicking submit, you are certifying that ALL information provided is true, complete, and correct. Any application received that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to be disqualified from further consideration for funding and may result in immediate discharge from the process, whenever it is discovered.