COVID-19 Response Needs Assessment 

Cheesh’na Tribal Council

HC01 Box 217

Gakona, AK 99586


Please take time to fill out the following requested information. This will allow Cheesh’na Tribal Council (“CTC”) the opportunity to deliver much needed assistance to our members, while maintaining compliance with the strict provisions on the use of the CARES Act funding. In addition, the information provided will allow CTC to connect our membership to existing financial assistance programs that may continue long after the pandemic.

The CTC Covid-19 Assistance Program intends that each tribal member and/or their household (including Non-Tribal), who can document a financial hardship which has been incurred as a result of the COVID-19 pandemic, may qualify to receive emergency financial relief.  

If you have questions please contact the Cheesh’na Tribal Council Business Office at the number listed above.









Please provide supporting documentation.



Please provide supporting documentation.

Medical and Safety

We understand that an increase in expenses is not just limited to bills. Other expenses not listed above meant to protect you medically and/or ensure your safety during this time, please document those costs above.

Hazard or Hardship

Extend beyond your financial and medical circumstances. We understand our members face challenges due to COVID, regardless of location, income and medical situation. Include financial impacts and needs related to hardship above.



I hereby certify that I have experienced financial hardship because of COVID-19 and further certify that the above information is true and correct to the best of my knowledge. I further understand that anyone who knowingly and willfully makes a false statement may be subject to criminal prosecution.