This is short-term financial assistance. If this application is accepted, you will be only eligible for our financial assistance for two years from the date of your first application.
We respect your privacy. We do not sell or rent your personal information to anyone, including third-party marketers. Your data is used to provide you with current and future services. Your data is anonymized and aggregated for fundraising and measuring impact. Please answer truthfully.
Have you been wrongfully convicted and released? If no, you do not qualify for our financial assistance.
YesNo
Name (required)
Email (required)
Phone
Address
City
State (required)
Zip
County of Residence (required)
SSN (required)
Birth date (required)
If you are affiliated with an innocence project, please provide the following information about that project.
Name of innocence project:
City/State
Lead attorney on your case
Attorney contact info (email or phone)
Incarceration has a significant negative impact on physical, mental, emotional, and social health. Please indicate all you have experienced since your release.
Physical issues (ex: diabetes, high blood pressure, asthma)Mental issues (ex: anxiety, depression)Social issues (ex: social isolation, distrust, family disconnection)Trauma and/or Stress (ex: PTSD related to experiences during incarceration)Other
If you checked, Other, please tell us about your experience.
How often do you experience trauma or stress related to your wrongful conviction?
Multiple times per dayDailyA few times per weekA few times per monthOccasionallyNever
What would you say are your TOP 3 needs today?
Affordable housingEmploymentEducation or job skills trainingMedical careMental health careChildcareFinancial literacy training (ex: budgeting, savings, retirement planning)Public speaking trainingOther
If you checked, Other, please tell us about your need:
What is your highest level of education?
No formal educationHigh school diploma or equivalentSome college experienceAssociate's degreeBachelor's degreeMaster's degreePhD or professional degree (ex: medical degree, law degree)
Have you received financial assistance from us before? YesNo
Have you received any compensation?YesNo
If yes, what year did you receive that compensation and how much money did you receive?
Do you have a compensation claim or civil case pending?
Are you currently employed? (required)
Full time (40+ hours per week)Part time (32 hours per week)Less than part time (less than 32 hours per week)Not currently employed
Average weekly hours:
What is the industry of your primary job?
What is your total yearly household income? (required)
How many people, including yourself, currently live in your household? (required)
What is your current living situation?
Rent a house or apartmentOwn a house or apartmentLiving with friends or family (not paying rent)Living in temporary housing (such as a hotel or halfway house)Unhoused
Please check all that you currently have:
Checking accountSavings accountCar loanHome loanStudent loanOther loanCredit card debt
What is your credit score?
Have you had any major life events in the last 12 months? Explain. (examples: married, divorced, new family member, death in the family, major car or house repairs, major medical issues) (required)
Have you been unable to pay a bill in the last 12 months? (required)YesNo
Briefly state what SPECIFIC FINANCIAL HARDSHIP this money will be used for. (required) (limit 50 words)
How did you hear about our financial assistance?
Upload any supporting documents - this includes PDFs or pictures of specific needs you stated above. Please make sure the documents include the account holder and any information needed to remit payment. These documents must have your name, account information, and where or how to pay. If the bills are not in your name, please provide an explanation as to why. Examples include rental agreements, phone bills, car repair bills, etc. Uploading these documents is required for the application process. We pay these bills directly rather than give you the money because you will not have to pay taxes on the funds. If your file is too large or you have multiple files, please email them directly to info@prunofund.org and upload a document stating they will be emailed so we know to look for them.
I affirm that the information provided in this application and the accompanying documents is true and accurate to the best of my knowledge. My signature indicates that I authorize The Pruno Fund, Inc. to verify any and all information. I understand and acknowledge that false or misleading statements of a material fact may be subject the applicant to prosecution under applicable laws. I further acknowledge that the Internal Revenue Service has the right to ask The Pruno Fund, Inc. for information, at any time, related to this application and the accompanying documents.
**PLEASE ALLOW US UP TO 3 BUSINESS DAYS TO REVIEW YOUR APPLICATION**
Sign (required)
Date (mm-dd-yyyy) (required)
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