If you are in need, please take the time to explain the situation you are facing so that we can make the best decision as to the help we may be able to provide.
Please fill out the form below to apply for financial assistance from Hamptons Community Outreach. Answer all questions accurately and truthfully — we will use this information to assess your eligibility for assistance. The application will be considered complete only if you upload 2 or more of the requested supporting documents. If we need additional information, we follow up with you to request an interview, schedule a visit to your home, or request additional information. All information you submit will be kept under strict confidence.
Take note: if you submit false documents or otherwise intentionally misrepresent your situation, you will be required to pay back any assistance we have awarded.
Disclaimer: By filing this application, you are authorizing HCO to evaluate my actual need for a grant. You understand and agree that the evaluation will include a financial review of your net worth (i.e., payroll information, tax returns, bank statements, etc.) and may also include interviews and a home visit. You certify that you have answered all of the questions on this application truthfully. You understand and agree that if you have not answered the questions truthfully, your application may be denied, and that even if you have already been selected to receive a grant, you may be disqualified from the program and forfeit any rights or claims to a grant. The original or a copy of this application will be retained by HCO even if the application is not approved. You understand and agree that you will not receive this application back nor or any of the documentation you submit with it. You also understand agree that HCO screens all applicants, which screening may include background checks and related searches. By completing this application, you consent to HCO conducting such searches and inquiry. By submitting this application, you are consenting to HCO’s policies and procedures, and to receiving HCO’s email communications regarding this application.