Apply For Funds
DOWNLOADABLE FILE: R91S Application for Assistance
The application can be emailed to email@example.com or mailed to: 2351 Sunset Boulevard, Suite 170-945 • Rocklin, CA 95765
The tragedy at the Route 91 Harvest Country Music Festival in Las Vegas on October 1, 2017, was the deadliest mass shooting in modern American history. On that night, 58 people were killed and well over 500 people were seriously injured. Countless others among the approximately 22,000 people attending the concert were physically injured in some fashion, have experienced post traumatic stress disorder and other psychological impacts, have been unable to go back to work and are getting behind on bills, or have experienced other undesirable effects associated with this unspeakable violence.
There are several organizations and funds that are predominantly focused on assisting the families of those killed at the festival, as well as assisting those who suffered severe physical injury at the festival. A few of these organizations include the Las Vegas Victims Fund (LVVF), Vegas Strong Fund (VSF), National Compassion Fund, Direct Impact Fund, national- or state-administered Victims of Crime programs, and GoFundMe campaigns. Route91Strong (R91S) is dedicated to helping a different segment of those who experienced the horror the night of October 1st – the survivors of this tragedy who were not shot but who nonetheless are adversely impacted by physical, emotional, or financial distress as a direct result of the attack. R91S intends to focus its initial efforts on those impacted by the tragedy in Las Vegas, but also intends to ultimately assist those affected by other subsequent tragedies.
R91S has developed a set of disbursement protocols (DPs) to measure the financial and other needs and distress of applicants in order to distribute its available funds in as prompt and equitable a manner as possible. The following steps outline the DPs that R91S intends to utilize initially. R91S reserves the right to modify these DPs over time as circumstances warrant and subsequent tragedies occur.
Survivors must complete and submit the R91S application for assistance form, which will include the following:
- Contact info (name, address, e-mail address, phone #)
- Personal data (last four digits of social security #, date of birth)
- Brief financial info, including current employment, annual household income, whether the survivor is the sole provider for the household, and how many minor children the survivor is financially responsible for
- Short description of physical, emotional, and/or financial impacts, which may include a brief statement of services received, treatments received or planned, name of employer (if available), lost wages, and types/amounts/duration of specific bills overdue
- Timeframe of impacts (start date, end date, or anticipated duration if still ongoing)
- Specific amount of disbursement requested, and why that amount is appropriate
- List of disbursements, funds, or any other forms of assistance from other organizations/funds, including state/federal disability and worker’s compensation, and the amounts received or expected to be received
- Proof of impacts, which may include medical records, receipts, contact info for physical/mental health care providers, invoices, statements, contact info for employer, employment records, paystubs, and any other documentation that the survivor deems appropriate and helpful and that R91S deems satisfactory (note that R91S will not request medical records directly from medical providers, nor will R91S share medical records voluntarily provided by applicants with anyone outside the R91S team)
- Acknowledgment that disbursements/awards are gifts from R91S made possible by the contributions of donors, that interpretation and application of the DPs are subject to the sole and absolute discretion of R91S, and that award decisions are final and not appealable
- Authorization for R91S to incorporate photos, testimonials, and other survivor accounts of those who receive R91S disbursements/awards into R91S social media forums, newsletters, and other publicity/media to raise awareness and money in accordance with its charitable purpose
- Waiver/release holding R91S harmless
- Certification that information provided is true and correct
- Signature and date of application
- Only one application should be filed by each survivor. Survivors are welcome to apply up to two times.
- Prompt medical treatment is not part of the criteria required for application approval or disbursement eligibility. It is recognized that some survivors were unable to secure medical appointments shortly after the trauma of October 1st, were unable to afford medical treatments, or were not immediately aware of the distress they are suffering. In addition, there is no deadline by which to submit an application; applications will be accepted and reviewed on a rolling basis.
- Priority will be given to survivors who have not received, or expect to receive, money from charitable and other sources.
- A telephone or in-person meeting may be requested by an applicant or by R91S as part of the application review process.
- Anyone listed on the U.S. Department of Treasury, Office of Foreign Assets Control, Specially Designated Nationals and Blocked Persons List (SDN List) will not be eligible to receive a disbursement.
- Disbursements will be treated as gifts, with no strings or obligations attached.
- Disbursements will be made on a first-come, first-served basis as applications are received, survivors are vetted, and money is available. Disbursements are anticipated to be made by check sent via U.S. mail. Disbursement/award amounts will be based loosely on the requests of each survivor, the urgency of survivor needs, and the unique circumstances of a survivor. It is anticipated that award amounts requested will exceed money available to distribute; the ratio (or percentage) of available money to requested disbursement amounts will also be used as a guideline to inform disbursement/award decisions for each applicant.
The application form may be downloaded above on this page, or requested through the Contact Us page of our website and received via e-mail from R91S. It is recommended that completed forms be scanned and e-mailed back to R91S via e-mail to firstname.lastname@example.org. Questions regarding requesting, completing, and submitting the application form can be sent via e-mail to email@example.com.
Beginning after 2018, a full audit of R91S will be conducted by an independent accounting firm following the end of each calendar year. The results of these audits will be made available to all claimants, donors, and the general public, along with a brief annual report prepared by R91S.
For information about services that support survivors, note that the Vegas Strong Resiliency Center connects Nevada and out-of-state survivors to social services, the FBI, Red Cross, Attorney General’s office, and advocacy groups; please visit the www.vegasstrongrc.org website. Additional information and resources are available through the Las Vegas Victims Fund at www.lasvegasvictimsfund.org/resources. Also, legal and financial toolkits developed by the Legal Aid Center of Southern Nevada, as well as other resources, can be found by typing www.lacsn.org/vegasstrong into Google.