The following questions are required and will be used to verify eligibility for the Grocery Worker's Appreciation Fund, to contact you if we have any follow-up questions, and to notify you if you are selected to receive financial assistance or specify exactly what is being awarded.

The Grocery Worker's Appreciation Fund is only available to current grocery store employees at this time. 
If you still need help, please call 211 or visit
You must be 18 years or older to apply for the Grocery Worker's Appreciation Fund.
If you still need help, please call 211 or visit
Please provide your direct email address.
Please tell us why you are applying for financial assistance.

Below are examples of a blocked-out paystub. 

Please block out all information except your name, the pay period and/or pay date of the paystub, and the name of your employer.   

Please do not e-mail your paystub or upload any other items like bank statements, direct deposit slips, identification, or other images as your application will be automatically disqualified.
Sample Paystub #1
Sample Paystub #2

Image files only (BMP, JPG, JPEG, PNG, etc.)
The following questions are for demographic purposes only and will not be used to determine eligibility for the fund.
By clicking SUBMIT, you agree and consent that all information provided on this form, including any and all personal and financial data is accurate and may be used by United Way Worldwide to evaluate your application for the Grocery Worker's Appreciation Fund and all such data may be shared with United Way Worldwide members, affiliates and partners. This data will be securely retained indefinitely.  To learn more about how United Way Worldwide uses and protects your data, please see the United Way Worldwide Privacy Policy.