Immediate Response Program Application Qualification Form

Campbell Soup Company Employee Disaster Assistance Fund

Fund Administered by Emergency Assistance Foundation, Inc.

Impacted applicants may apply for a one-time grant of $700.00 per household for the purpose of food, clothing or other basic needs. The intention of these grants aligns with the charitable purpose of the Fund. Verification that the application is a member of the charitable class, was impacted by the event, and meets the criteria for assistance will take place, prior to grant approvals. Impacted applicants need to complete and sign this form. If you have any questions, please email

I would like to complete the Immediate Response Program Application Qualification Form and have read and accept the privacy policy and terms of use.

CRITERIA 1 - Primary residence was affected by “Disaster Event” causing applicant to be evacuated, displaced, stranded or significantly impacted.

CRITERIA 2 - Applicant is in need of food, clothing or other basic immediate needs.

Please type your first legal name.

Please type your last legal name.

Please type your best contact E-mail.

Please enter the last four digits of your employee ID.

Please type the year you were born.

Would you like your Fund contact to reach out to you so you can share your story with others?

I certify that I was impacted by the “Disaster Event”, meet the “Criteria” described above and that all the information on this application is true and correct and I understand that no applicant is guaranteed to receive a grant unless they meet the criteria. I understand that no applicant is entitled to receive a grant, either by their employment, their history of contributions to the Fund or because of any precedent inferred from previous grants from the Fund. The Emergency Assistance Foundation, Inc. reserves the right, in its sole discretion and for any reason, to deny any application it receives. I understand that a grant approval does not guarantee payment to any party, and that grants will not be made unless the fund has sufficient monies to pay existing grants. Emergency Assistance Foundation, Inc. will use and otherwise process personal information obtained in connection with this application in accordance with and for the purposes described in the Privacy and Cookie Statement and Terms of Use. I certify that the information provided in this grant application and any documentation is true and correct as of the date this application is submitted. My electronic signature below acknowledges and permits Emergency Assistance Foundation, Inc. to obtain or verify all information necessary to process this application. In its due diligence, if the Foundation discovers any information to be untrue, it shall have the right to waive all confidentiality and report its findings to our Fund Partner (your employer). Any intentional misrepresentation or material omission of information or documentation contained in this application will result in forfeiting this and any future grant applications. I understand that the Fund Partner (your employer) company may also take corrective action up to and including the termination of my employment.

By typing my name in this box as my electronic signature, I acknowledge that I agree to and understand the terms above.

Please complete this simple calculation 6 + 3