Family in Need

Are you a family in need, struggling with the basic requirements of running your home, feeding your loved ones or an unexpected emergency? You are our friends and neighbors. Tell us more about your situation to see if Team Buche Cares can assist.

Team Buche Cares’ focus remains on communities and families in rural South Daktoa. Requests for funding will be presented to the Team Buche Cares Board of Directors. Please note that submitting an application does not guarantee approval. Because of the high demand and the uncertainty of available funding, assistance cannot be guaranteed. Only one application may be submitted per calendar year. Successful applicants will be contacted directly by the Team Buche Cares.

Assistance Program Application

"*" indicates required fields

Family's Name*

Enter head of household

First Last

Family's Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Please tell us more regarding why you are requesting assistance:*

Type of Assistance Requested & Amount

List any assistance the family in need may require, including the amount needed.

Type of Assistance Requested & Amount*

List all expenses you are requesting assistance for including travel, lodging, medications, meals, medical supplies and other living necessities.

Expense Item

Expense amount ($)

Total Amount Requested*

Who will be picking up the contributions?*

Individuals picking up gift cards will need a valid ID. Please include First and Last Name.

If picking up assistance at one of our stores, which location?

How did you hear about this assistance application?*

Please enter first/last name, store location or any other details.

Signature*

Date*