On April 23, 2020, Tribal Council approved the COVID-19 Relief Payment Program (“Program”) to ensure all eligible Tribal members, 18 years of age and older, will receive stipends for the unexpected costs or loss of income during the COVID-19 pandemic and public health emergency. The Program provides financial assistance to eligible tribal members to help alleviate the hardships endured during this time.

Following the Tribe’s adoption and implementation of the COVID-19 Relief Payment Program, the U.S. Department of Treasury issued new guidance related to the Program. The new guidance requires that each Tribal member must complete an application for the Program.

One application per eligible member, 18 years of age and older as of payment dates: October 16, 2020 and November 16, 2020.

Please submit your completed application by October 9th, 2020. Failure to do so WILL delay payment. In order to prevent unnecessary contact during the COVID-19 pandemic, please follow one of the submission guidelines below: 


  • Please complete the online application below and click submit at the bottom of the page. If you do not see a submission confirmation page after clicking submit, please review your application for missing information. Most fields are required for submission and leaving them blank will prevent you from submitting the application. 


  • Download and print the application here.
  • Complete the application and then do one of the following:
  • Scan and email to with the subject title: Relief Payment Application or,
  • Fax to 503-879-2208 or,
  • Mail to – Confederated Tribes of Grand Ronde, 9615 Grand Ronde Rd., Grand Ronde OR 97347 Attn: Finance Department

All financial support will be sent to the recipient per their Per Capita payment election, either direct deposit or mailing address.
If you have any questions, please contact Liz Leno by email at


Contact Information
Household Information
Employment Information

Housing Information


I hereby certify that my family has been impacted by the COVID-19 pandemic prior to and since Resolution #101-20: Declaration of Emergency on March 18, 2020, and I have a financial need due to loss of employment and income and increases in costs as a result of the public health emergency. As a result, I am requesting assistance through the COVID-19 Relief Payment Program. I also certify that the information submitted on this application is true and correct to the best of my knowledge.

IF YOU DO NOT SEE THE SUBMISSION PAGE AFTER CLICKING SUBMIT, please review the form for missing information. Most fields are required and will prevent you from submitting an incomplete application. Thank you!