Ruby Has Heart (RHH) provides grants for Team Members of Ruby Tuesday who have had an unforeseen
circumstance or emergency resulting in severe financial need. RHH was established to provide assistance with the
following:
• Short-term help for basic human needs (I.e., clothing, food, travel and lodging) after a fire, flood, hurricane or
other natural or manmade disaster.
• Burial/Funeral assistance for the passing of a Team Member or immediate family member.
• Financial hardships due to unforeseen circumstances (outside the scope of insurance) for those who request
short-term help for basic human needs (i.e., clothing, food, travel and lodging).
Basic Guidelines for Application:
• Active full-time and part-time 90-day tenured Team Members and Managers are eligible to apply. Definition of
“active" is holding active status in the Ruby Tuesday payroll system or being on approved leave of absence at
the time of application.
• When filling out the Application for Emergency Assistance, please remember to complete all sections.
• Applications must be complete in order to process. This application as well as any materials sent will become
property of the Ruby Has Heart Fund. Please do not send original bills.
Please send the following required information:
• Official documentation of unforeseen situation (fire report or other official report; photos, newspaper articles,
funeral home contracts).
• Any additional information that might be helpful in providing an accurate assessment of your needs.
(The amount of financial assistance will be determined by the RHH.)
Unfortunately, the Ruby Has Heart Fund cannot:
• Replace lost income.
• Be a substitute for disability or medical insurance.
• Be used for debt consolidation.
• Replace expenses derived from non-emergency circumstances.
Please return application with additional documentation
Ruby Has Heart Fund
Attn: Clara Heaton
216 East Church Avenue
Maryville, TN 37804
Fax: (865) 379-6817
Email: [email protected]
Questions? Please call 1-800-325-0755 Ext. 5824
Team Member Information
First Name
Middle Initial
Last Name
XXX-XX-
Last 4 digits of SSN
Phone
Street Address
Apt #
City & State
Zip
Personal e-mail address
Employment Information
Location of Ruby Tuesday where you are currently
employed
House Code or Department
Position Held
Hire Date
GM or Supervisor Name
Business Phone
Dependents
Relationship
Age
Current Address
Financial Information
Net Pay of Ruby Tuesday Team Member
Net Pay of Spouse
Disability/Retirement
Other (Child Support, Unemployment, State or Gov’t assistance)
TOTAL MONTHLY INCOME
Bank Accounts
Type of Account
Bank or Financial Institution
Balance
$
$
Monthly Household Expenses
Monthly Expense
Amount
Rent/ Mortgage
$
Utilities
$
Phone
$
Food
$
Clothing
$
Child Care
$
Car Payment
$
Car Insurance
$
Transportation (fuel or bus fare)
$
Credit Cards
$
Other (Explain)
$
TOTAL MONTHLY EXPENSES
$
EXPLANATION OF EMERGENCY SITUATION CAUSING FINANCIAL HARDSHIP
PLEASE READ AND SIGN:
RELEASE OF INFORMATION: I authorize my payroll office to release information pertaining to my earnings,
work status and/or leave information, and for the RRF to receive information from my GM (or supervisor if
employed at the Support Center) as deemed necessary. I have read the RRF guidelines and agree for my name
and a brief explanation of my hardship to be released to the RRF.
I understand that it is my responsibility to report any change in my employment status, any change of address,
any change of dependent care, and any change in family income and that providing inaccurate information may
result in disqualification for consideration for aid.
By signing below, I certify that I am employed by Ruby Tuesday and have fully and truthfully completed this
application, and that I have no assets that could reasonably be used to satisfy this emergency.
Team Member Signature General Manager or RSC Supervisor Signature
Team Member Printed Name GM or RSC Supervisor Printed Name
Date Date
(Application must be signed by your General Manager or Support Center Supervisor to be processed.)
Amount of Grant Requested: $