COVID-19 Response Needs Assessment 

Cheesh’na Tribal Council

HC01 Box 217

Gakona, AK 99586

907-822-3503

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.

  • Personal Information

  • Household Information

  • Household Income

    Please provide supporting documentation
  • (TANF, SNAP, etc)
  • (TANF, SNAP, etc)
  • (Child Support, Royalties, VA, etc)
  • (Child Support, Royalties, VA, etc)
  • Household Expenses

    Please provide supporting documentation
  • (cable, internet, phone)
  • (cable, internet, phone)
  • 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.

  • Date Format: MM slash DD slash YYYY