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Search
Search
About Us
Annual Report
Board of Directors
Communities We Serve
Financial Accountability
Investment Plan
Staff
Give
Flood Recovery Fund Support
Leadership Giving
Billboard Campaign
Event Sponsorship
Forever Fund
Gift Planning
Workplace Campaigns
Why give to UWNEMN?
Our Work
Babysitter Training
Bright Beginnings
Buddy Backpacks
Comforts of Home
Imagination Library
Lunch Buddies Mentoring
Meet Up and Chow Down
Smiles United
Step Into School
United for Veterans
Operation: Service Story
Veterans Connections
Youth United
Day of Action
Partners
Fund Distribution Process
Iron Range Partner Agencies
Koochiching & LOTW Partner Agencies
Events
$10,000 Golf Ball Drop
Annual Celebration
Bucks for Backpacks Raffle
Flavor of the North
Koochiching County Restaurant Week
Power of the Purse
Renegade Trail Run
United for Veterans Cash Raffle
Need Help?
Flood Help
News
Thank You Gallery
Volunteer
Meet Up and Chow Down
Contact Us
Make a Comforts of Home Referral
UWNEMN's Comforts of Home program is meant to be a one-time use program.
If your client has mitigating circumstances, please contact
sarah@unitedwaynemn.org
to discuss further.
Case Manager Contact Information
Name
Company
Email
Phone
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Client Information
Client Name
Please check this box if your client has used the Comforts of Home program in the past.
Number of Adults in Household
Number of Adults in Household
- Select -
1
2
3
4
Other…
Enter other…
Ages of Adults in Household
Number of Children in Household
Number of Children in Household
- None -
1
2
3
4
Other…
Enter other…
Ages of Children in House
What community will this family or individual be living in?
Please enter a rough estimate of the family or individual's yearly income:
- Select -
$1,000 - $5,000
$5,000 - $15,000
$15,000 - $25,000
$25,000 - $45,000
$45,000 - $60,000
$60,000 +
Please describe this family or individual's crisis and why they are being referred to the Comforts of Home program.
Submit
Leave this field blank