Set forth the nature of the bill, invoice, estimate etc. for which you are requesting funds. Include the amount of assistance requested, up to $750*, and attach hereto a copy of the related bill, invoice and/or estimate. Please ensure the creditor’s return billing address is included and clearly marked. Include the reasons or circumstances giving rise to the need for financial assistance and detail how the requested grant will resolve the situation. Attach an additional page, if necessary and copies of supporting documentation.