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Requests for Aid (Personal)

Enter a financial aid request for a personal or individual project. To apply for financial aid for a startup, a microcredit for a company or a community project, use this form.

Submit an Aid Request

Form Defaults

Create an account to enable saving this form
please submit your financial information in the local currency

Form mode

You are editing in REPORT mode. Reporting sections are highlighted in this color.

Personal

1) Recipient Data

Employment

2) Employment and Family Income

Family Income

local currency
please describe

Jobs

Please add a job status for all family members of working age. Click "Add" only if you need to enter a 2nd, 3rd and so on, worker.
Add another job entry Remove the last job entry

Difficulties

3) Difficulties Faced

Is the EoC financial help expected to have a direct effect?

Direct: The help directly contributes to solve the problem
Indirect: The help covers some expenses while looking for major solutions to the problem

Main Cause of Need     (select all that apply) EoC help will be:
 
Indirect
Direct

Existence of other aid

Outcomes

Type of Eoc Help & Cause of Need Problem Solved? If Yes, Role of EoC Help
 
Yes
Partial
No
Yes
Partial
No

Projects

4) Personal Project

Purposes of the Help

In this section, you will add the specific OBJECTIVES OF THE AMOUNTS TO BE GIVEN and of the HELP RELATIONSHIP established. Objectives are concrete and verifiable, and contribute to the general implicit objective of solving (or mitigating) the need condition identified in the previous section.

Situation 1 - Both parents were laid off and have little money to buy food for the family

  • Economic security: to enable the family to maintain its level of food consumption after the layoff of both parents
  • Relationships development: to give the children opportunities for sport and youth group activities

Situation 2 - An accident injured a family member and the medical expenses are a burden

  • Personal education, training, health: support for medical expenses after an accident

Situation 3 - A flood damaged the workshop of a carpenter, leaving him with no tools to perform his work

  • Economic Security: to enable the carpenter to start working again after a flood partially destroyed his workshop

Situation 4 - The father of the family holds a job which does not provide enough income for his family

  • Economic Security: to attend 3 years of a course for computer technicians
  • Personal education, training, health: to allow acquisition of professional skills as computer technicians

Actions

In this section, add the CONCRETE ACTIONS needed to achieve the objectives, plus any complementary actions which can contribute to the effectiveness of the help or to solve the main poverty problem.

Situation 1 - Both parents were laid off and have little money to buy food for the family

  • Use of funds: covering the monthly expense for fruit and vegetables
  • Non-financial or complementary: addressing the unemployed head of family to local employers
  • Non-financial or complementary: to signal to the family youth groups active in their area

Situation 2 - An accident injured a family member and the medical expenses are a burden

  • Use of funds: paying one surgical intervention

Situation 3 - A flood damaged the workshop of a carpenter, leaving him with no tools to perform his work

  • Use of funds: buying building materials
  • Non-financial or complementary: the carpenter and his brother make their labor available

Situation 4 - The father of the family holds a job which does not provide enough income for his family

  • Use of funds: covering 50% of course fee
  • Non-financial or complementary: to be in contact with centres for employment (if not done by the school) or with EoC entrepreneurs in the IT field
Add Remove

Financial Request

5) Financial Request

local currency
local currency
local currency

Length of Help

All financial aid is intended to be temporary. At the end of the year, specific motivations for continuing the financial aid in the following year will need to be provided.

Choosing yes will duplicate the need request and you will be redirected to make any changes for the next year.

Outcomes

6) Immaterial Outcomes

This section will be filled out with the help of an EoC commission member.

shown by the receiver of the help
Sending
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