Request edit access
Central Coast Labor Council Workers Relief Fund
If your home was lost, damaged or you're are unable to return to your home for a prolonged period of time, please fill out and submit the form below.

Alternatively you can CLICK HERE: https://tinyurl.com/ydcxx95k or send the requested information to daniel@centralcoastlabor.org or call 805-987-0101.

Once you've completed this form, emailed or called us -- we will be touch. Please be prepared to let us know which union you are a member of and before we can send you a check, we will need some form of documentation of your loss (i.e. a form from FEMA, the county or your insurance company).
Sign in to Google to save your progress. Learn more
Name *
Address, City *
Cell Phone Number *
Email Address *
What union are you a member of? *
Please briefly describe your hardship: (Description of loss, percentage of loss, extended displacement due to smoke, etc.) *
How many family members live in your household?
How many children live in your household?
Do you have any immediate needs that we can help you resolve?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Central Coast Labor Council. Report Abuse