Serving Carbon and Monroe County Pennsylvania

Hardship Heroes Experience Application

The Hardship Heroes Experience is our year-round initiative that gifts personalized experiences to individuals or families navigating intense or ongoing hardships. Whether someone is dealing with medical challenges, financial strain, caregiving responsibilities, or the weight of grief and mental health struggles, we believe they deserve a moment that is just for them, a chance to feel seen, celebrated, and supported.

These experiences are thoughtfully curated to reflect each hero’s interests and needs. They could include things like a peaceful weekend getaway, a family activity day, a makeover, a private concert, or something completely unique.

Our goal is simple: to make sure every hero feels seen, heard, and appreciated while giving them a chance to create lasting memories beyond their hardships.

Are you applying for yourself or nominating someone else?

I am applying for myself

I am nominating someone else

First name

Last name

Phone

Name of Nominee (if different)

Nominee's Phone number

Nominee's Email

Nominee's Address

Tell us about the individual or family you're nominating. Who are they? What makes them special?

What hardships has this person or family faced? Please use this space for detailed information relating to their hardship.

What hardships has this person or family faced? We’re looking to support and recognize people who have faced significant hardships and adversity. Please check all that apply!

Why do you believe this person deserves a Hardship Heroes Experience?

Is there a specific experience, gift, or support item you think would mean the world to them?

Would you be able to provide documentation of your hardship if requested?

Yes, I can show documentation

No, I cannot show documentation

It would be difficult to show documentation

Please provide 2 references familiar with your situation. One may be a family member. The other must be non-family (social worker, employer, doctor, clergy, etc.)

Reference #1 Full Name

Reference #1 Email

Reference #1 Phone

Reference #2 Full Name

Reference #2 Email

Reference #2 Phone

Eligibility Requirements

To help us maintain a safe, respectful, and supportive environment for everyone involved in a Hardship Heroes Experience, we ask that you answer the following question honestly.

Have you, or anyone in your immediate household or the individual(s) you are applying on behalf of, been involved in any criminal investigation or conviction, had any history of violence, abuse, or restraining orders related to domestic disputes, been the subject of allegations or findings of child abuse or neglect, are currently involved in any pending legal matters that could impact participation in a public or shared event, or have experienced any other circumstances that may pose a safety or reputational risk to our organization, volunteers, sponsors, or other recipients?

Please check one

Yes

If you answered yes to the above questions please provide more information below

I confirm that the Hero resides in Carbon or Monroe County (or bordering areas in Lehigh/Northampton County)

I confirm that the Hero has experienced qualifying hardship as listed above

Media & Advertising Release

I give permission for Hardship Heroes to use photos, videos, and my story for promotional and fundraising purposes

Thank you for taking the time to share your hardship with us. We know how challenging a time like this can be. Once we receive and review all applications for our Hardship Heroes Experience, our team will carefully evaluate each submission and applicants will be notified of their status via email. Thank you for trusting us with your story.

Peace & Love,

The Hardship Heroes Team