MercAid Request Form

MercAid is a mutual aid program established to provide a modest amount of financial support to current co-op employees at times of personal crises.

MercAid is funded through voluntary employee contributions, made as automatic payroll deductions. Employees may elect to contribute a minimum of $1.00 per pay period with no maximum set.

Application/Nomination Process:
An application/nomination for a MercAid donation can be submitted by the person directly involved in the crisis situation or by another employee. Application/nomination should be submitted by letter or ping to one of the MercAid committee members( Rod, Becky, Daniel, or Patty M), or by using this online form.

The maximum donation amount that can be requested for any one crisis situation is $500. The approval of the application and actual amount of the donation will be decided by a consensus of the MercAid Committee on a case-by-case basis.
MercAid funds are available to any active employee in good standing, full or part-time, beginning 90 days from start date of employment whether or not you contribute to the fund. Staff are eligible to apply once per calendar year.*
- *Special allowances may be made subject to the approval of the committee.

Name

Employee Number

Requested Aid Amount

If this request is for someone else, feel free to leave this blank.

Please describe your need (or the need of a coworker, if submitting for another employee)

Provide any information you're comfortable sharing with the committee. This information is confidential to the MercAid team and will not be shared with other staff.