The Tractor Supply Company Employee Assistance Fund

APPLICATION FOR MAJOR NATURAL DISASTERS

This Fund helps Tractor Supply Company team members who are experiencing hardship because of a major natural disaster.  Those not living in such areas who have  been affected by another hardship should complete a different application found here: https://cfmt.formstack.com/forms/tscemployee or contact The Community Foundation for access to the appropriate application.

To qualify for this program and receive assistance you must meet all of the requirements detailed below and submit all required documentation. 

GRANTS: The maximum grant amount available for assistance is $5,000. The maximum award is not guaranteed, and in many cases, a lesser amount will be awarded.

Community Foundation staff is available to assist all applicants with this process email EmergencyGrants@cfmt.org or call 615-321-4939 and select extension 128 or 113.

Do You Qualify?

To qualify for this program and receive assistance you must meet all of these requirements:

If you do not meet one of the requirements above, please send an email to EmergencyGrants@cfmt.org to discuss your situation with a member of our team.

You will need these things to complete this application:

  1. Detailed information and exact dates related to your incident
  2. Required documentation related to your incident*
  3. Payment information for the expenses for which you wish to receive assistance (housing costs, utility bills, medical bills)*

If you have questions about any of the above, please send us an email to EmergencyGrants@cfmt.org

*NOTE: You will be able to start your application and submit this form even if you do not have #2 or #3, but you cannot be approved for assistance until we receive all of the requirements listed. If you submit an incomplete application, you will be able to submit the missing information at a later time. 

Contact and Employment Information

Name*

You will receive a confirmation email when your application has been successfully submitted. Please use an email address you currently have access to.

Address 1*
Can you currently receive mail at this address?*
Current Mailing Address

We must have a current mailing address in order to be able to send funds to you. Provide an address for which you can receive mail in a timely manner.

Is it okay for us to leave a message?
Is it okay for us to leave a message at this number?
You can estimate the date if you were hired over 2 years ago
Date of the incident, missed work or positive test
Enter the date of the incident that is causing your financial difficulty.
Have you lost income or gone without pay because of the virus?
Has another wage-earner that supports your household lost income or been laid off due to the virus. (Including someone paying court-ordered child support)
Have you used PTO/sick time/vacation to make up for lost pay?
Check all that apply to your situation:
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Describe Your Situation - Natural Disaster

(e.g. hurricane, tornado, flood, storm etc.)
Date of the incident*
Enter the date of the incident that is causing your financial difficulty.
Describe your housing arrangement at the time of the disaster*
Is your rental payment made to:
Are you responsible for any repairs to your rental property?*
Damage to the outside or structure of your home - check ALL that apply
The Fund cannot pay to repair other property such as fencing, carports, garages, or storage buildings.
Damage to the inside of your home
Damage or loss of your belongings - check ALL that apply
The Fund cannot pay to replace non-essential items, such as electronics.
Clothing and personal items
Is the damage to your vehicle covered by insurance?*
Have you been displaced from your home?*
Where have you stayed away from your home?
What kind of documentation or paperwork do you have that shows your losses?
Have you lost power or other utility services at any point?*
Which essential services have been out?
Have you registered for assistance with FEMA?*
This will not affect assistance you receive from this program.
Do you expect insurance of any kind be used to cover your losses?
Type of Insurance?
Tell us more about how insurance will be used to cover your losses
Tell us about what won't be covered
Your absences may be verified with your employer
How many unpaid days of work have your or other wage-earners in your household missed?

Documentation

You will need to submit documentation that reflects the impact of this disaster on you and your household.

There are different types of documentation that you can send. Choose the option that is easiest for you.

  • You can send photographs. Please make sure that photos show the damage clearly.
  • You can submit a report from your insurance company if it describes the damage
  • If you incurred expenses due to the disaster, you can submit receipts.
  • You can send FEMA paperwork (if you have it) that details the damage or loss.
  • Documentation can be sent separately from your application. Include your name with every item that you send so that it can be matched with you application.

Upload the relevant files below or send them by email to EmergencyGrants@cfmt.org with your name in the subject line.

Once you upload your first document, you will be given an option to upload additional items.

Are you uploading documentation through this form?

Document #1

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Document #2

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Document #3

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Document #4

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Document #5

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Document #6

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Assistance Grants - Natural Disaster

The maximum allowable grant amount is $3,000. Not all applicants will receive the full amount, and no specific grant amount is guaranteed.

The total grant amount awarded to each applicant varies and is based on your documented financial impact, hardship, and demonstrated need.

Once approved, a member of our team will contact you to confirm the best way to provide you with assistance.

Permission for Other Contacts

If you would like for someone else to provide support or help with this application, you will need to give permission below. It could be a co-worker, your supervisor, a family member, someone from the Employee Relations Team, or anyone you choose. We can work with anyone that you designate, as long as you give your permission. You are not required to provide a second contact; this is optional.

I give permission to contact TSC human resources or another person for help with my application, if needed.
I give permission to contact them by:

Share Your Story

Sometimes we reach out to past applicants and ask if they would be willing to talk about how this fund has helped them. We may use your experiences, quotes and/or testimonials to help promote the program and to make sure this same assistance is available to others. If you would be willing to have someone from The Tractor Supply Company contact you in the future, please give your permission below. This is optional and will in no way affect your application or the grant you may receive. The Community Foundation of Middle TN will only share your contact information and not the details of your situation.

I give my permission for a representative of Tractor Supply Company to contact me and ask about my experience with this program.
I can be reached by:

Agreements and Acknowledgements

No employee is entitled to receive a grant, either by their employment, their history of contributions to the Fund or because of any precedent inferred from a previous grant from the Fund. Grants will not be made before an applicant has demonstrated an immediate financial need and provided all required documentation.

This application will be treated in a confidential manner by The Community Foundation of Middle Tennessee; however non-identifying statistical information will be reported to the Company on a periodic basis.

Employees are expected to provide truthful and accurate information. In its due diligence, if The Foundation discovers any information to be untrue, it shall have the right to unilaterally waive its confidentiality and report its findings to the Company. The fiduciary expectations of all employees are paramount and a breach of these standards will be reported to your employer.

Your signature below certifies that the information provided is true and complete, authorizes The Community Foundation to obtain and/or verify all information necessary to process this application, and releases the Company and The Community Foundation of Middle Tennessee from any liability associated with the rejection of or funding of this application. Remember the total grant amount available for assistance varies and is based on each applicant’s documented financial impact, hardship, and demonstrated need. No award amount is guaranteed, as each case is evaluated individually according to the program guidelines In addition, you agree to provide the requested documentation supporting the information provided.

Acknowledgements*
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