ONE PURPOSE OF THE STEELWORKERS CHARITABLE AND EDUCATIONAL ORGANIZATION IS TO ASSIST STEELWORKER MEMBERS WHO HAVE SUSTAINED FINANCIAL LOSS AS A RESULT OF NATURAL DISASTERS. INFORMATION PROVIDED WILL BE KEPT CONFIDENTIAL. DUE TO THE AVAILABILITY OF FUNDS, THERE IS NO GUARANTEE THAT ALL REQUESTS WILL BE GRANTED.

Required Field Invalid Field


MEMBER INFORMATION
USW District Required
Local Number Required
First Name Required
Last Name Required
Phone Number Required  
 
USW District Required
Number of Dependents Required  
4-Digit SSN Required  
Address Required

City Required
State/Province Required
Postal Code Required  
Answer Required

EMPLOYMENT INFORMATION
Employer Name Required
Address Required

City Required
State/Province Required
Postal Code Required  
Last Date Worked Required  
Answer Required
Answer Required
Answer Required

DAMAGE INFORMATION

Please provide detail for the items for which you need our assistance. Please do your best to approximate the damage. Estimates can be in USD ($) or percentage based on the Total Estimated Value.

PROPERTY #1

Property Type Required
Total Value Required  
Estimate Type Required
Damage Estimate Required  
Amount Reimbursed Required  

PROPERTY #2


 

 
 

PROPERTY #3


 

 
 

PROPERTY #4


 

 
 
EMERGENCY INFORMATION



REVIEW & SIGN

The above information is accurate to the best of my knowledge.

Signature Required