Serving Carbon and Monroe County Pennsylvania

Hardship Heroes Quick IMPACT Application

Quick IMPACT Cards provided by Hardship Heroes offer immediate assistance to individuals facing urgent hardships. These cards help cover essential needs such as groceries, clothing or general support. They ensure timely support during critical times. By providing Quick Impact Cards, we can swiftly alleviate specific challenges, offering a crucial lifeline to those in need. Those who apply for Quick IMPACT Cards are usually facing unforeseen furloughing, house fires, work related accidents or unexpected health crisis from car accidents. A $250 gift card may not seem like much but it can cover short term, quick access to things like groceries, clothing or even a small bill.

Our goal is simple: to help families with comfort in a time of need or hardship. To create small acts of kindness that will have a ripple effect.

Quick Impact Gift applications are open year-round and reviewed on a rolling basis. We aim to respond quickly so we can deliver support when it's needed most.

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!

What type of IMPACT Gift Card do you think would be beneficial for this situation? (Visa, Amazon, DoorDash or grocery)

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