GHCA Disaster Relief Fund Submission Form - Hurricane Helene

GHCA’s Disaster Relief Fund is available to support member center employees located in areas impacted by natural disasters such as Hurricane Helene. Each submission will be reviewed on a case-by-case basis, with priority given to those residing in areas of significant impact*. Financial assistance from the fund will be distributed to individuals directly to the address provided in the application.

Deadline for Submissions: November 1, 2024. If you have questions, please contact info@ghca.info.

*Counties included in the current State of Emergency as extended by Gov. Brian Kemp through October 16: Appling, Atkinson, Bacon, Baldwin, Ben Hill, Berrien, Bleckley, Brantley, Brooks, Bryan, Bulloch, Burke, Butts, Camden, Candler, Charlton, Chatham, Clinch, Coffee, Colquitt, Columbia, Cook, Echols, Effingham, Elbert, Emanuel, Evans, Glascock, Glynn, Hancock, Irwin, Jeff Davis, Jefferson, Jenkins, Johnson, Lanier, Laurens, Liberty, Lincoln, Long, Lowndes, Madison, McDuffie, McIntosh, Montgomery, Newton, Pierce, Putnam, Rabun, Richmond, Screven, Taliaferro, Tattnall, Telfair, Tift, Toombs, Treutlen, Turner, Ware, Warren, Washington, Wayne, Wheeler, Wilkes, Wilkinson, and Worth.
1.Recipient/Employee Name:
2.Phone Number:
3.Home/Mailing Address:
4.Personal Email Address:
5.County of Residence:
6.Provide a detailed description of the loss incurred and/or a detailed description of property damage, if applicable.
7.Facility of Employment:
8.Facility Address:
9.Employment Status:
10.Employee’s Position:
11.Administrator Name:
12.Administrator’s Email:
13.Administrator’s Phone: