Apply For Assistance

The Maury Magids Foundation is currently accepting applications for financial assistance. If you have lost a family member to suicide and you are in need of financial assistance, please fill out the application. Please note that we cannot guarantee selection, but our team will be in contact with all applicants as soon as decisions are made.

Your Name

First Name

Last Name

Phone

(###)

###

####

Deceased Family Member's Name

First Name

Last Name

Your Relationship to the Deceased

Please select who your family member was to you

Date of Loss

YYYY

Age at Time of Passing

Please provide the deceased's age at the time of their passing

Impact of Loss

Please briefly describe how losing your family member impacted you and your family

Financial Need

Please explain your current financial situation and challenges

Monthly Income and Expenses

Please explain your family's current monthly income and expenses

Was Your Family Member An Income Partner?

Did your family member provide for your family? If so, please also provide their monthly income.

Intended Use of Funds

How would funds assist your family?

Current Support System

Please state what resources are currently available for your family

Other Information

Use this section to provide any other information you would like us to know