Application for support

Application for Grocery Support
This form is for food and grocery support. Please DO NOT ASK for financial help, rent payment or any other bills

هذا الطلب هو لدعم الأكل و توفير المواد الغذائية فقط. الرجاء عدم طلب مساعدات مالية ، أو دفع الإيجار أو أي فواتير أخرى

IMPORTANT: Please fill in this form ONCE ONLY as multiple submissions will delay your application.

As of June 2020 we are only accepting families with PROOF OF NO INCOME and with children under 6 years old living here in the UAE as a priority.

If there is any missing information your application will not be processed.

After you submit the form, you will receive an email from Stop and Help. Check your inbox including the SPAM/JUNK folder.

Please be patient and stay safe.
Name as it appears in your passport (you may be required to show this on delivery) *

First Name Last Name
Email *
Please DO NOT use @yahoo emails
Nationality (Which country are you from) *

Street Address

Street Address Line 2

Country
Religion
Please confirm which of these reflects your household salary situation *

Father is receiving full salary Father is on reduced salary Father is not working
Father is not working due to *

Job Termination Unpaid Leave Visit Visa
Father's Salary Reduction % *
*

Mother is receiving full salary Mother is not working Mother is on reduced salary
Mother is not working due to *

Job Termination Unpaid Leave Housewife Visa Visit Visa
Mother's Salary Reduction % *
Name of your first child under 12 years old *

Name Age
Child's gender

Girl Boy
Name and age of your second child under 12 years old

Name Age
Second Child's Gender

Girl Boy
Name and age of your third child under 12 years old

Name Age
Third Child's Gender

Girl Boy
Number of people in the household - please tell us who they are *

Number e.g. Mum, Dad, 2 children
Address *

Apartment / Room No

Building Name, Street Name

Street Name Area

(any nearby landmarks)
Emirate *
Map Pin location

Please copy and paste your Google map location here

Street Address Line 2
Your Location Plus Code (Find your location on the map above then copy and paste the code)

Street Address Line 2
Move the red pin to your location to get your Plus Code
Contact Telephone *

Code Phone Number
Whatsapp Number (if different)

Code Phone Number
(IMPORTANT FOR DELIVERY) Mobile number of someone else in your household *

Code Phone Number
Why does your family need Stop and Help support?
In addition to food and essential groceries are there any baby items you need urgently? *

None Diaper size 1 Diaper size 2 Diaper size 3 Diaper size 4 Diaper size 5 Diaper Size 6 Formula Milk stage 1 Formula Milk stage 2
Please specify formula brand or special dietary requirements for your child
Have you received support in the form of groceries or vouchers through Stop & Help?
How many times did you receive support?
Other (please specify how many times you've received support) *
Upload one of the following for EVERY member of household: Emirate ID(s). If no EID, VISIT VISA. If no Visit Visa for baby, UAE Birth Certificate(s). Files should be max 1mb. *

Browse Files
NB - You are under no obligation to provide this documentation, but without evidence of residency in the UAE we will not take your application any further. Cancel of
Upload one of the following for EVERY member of household; 1. Letter of Termination from UAE company OR 2. Letter of Salary reduction from UAE company OR 3. VISA Cancellation document (if housewife) OR 4. Proof of VISA in passport. Files should be max 1mb. *

Browse Files
NB - You are under no obligation to provide this information, but priority for support is given to people who can demonstrate that they have no income to provide for even basic needs. Cancel of
Upload the following for both parents; the most recent copy of UAE VISA. Files should be max 1mb. *

Browse Files
NB - You are under no obligation to provide this information, but priority for support is given to people who can demonstrate that they have no income to provide for even basic needs. Cancel of
IMPORTANT - YOU MUST CLICK EACH OF THESE TO SHOW YOU HAVE READ AND THAT YOU AGREE. (please note you are under no obligation to send in pictures but if you do the following terms apply)

I confirm all the above information is correct and I have supplied all the information I have in my possession to support my application. If I have not provided enough information I understand that my application may be rejected without explanation. I confirm that I give my consent to Stop & Help and any individual or legal person responsible for the administration of the initiative (“Stop & Help”), to: (a) store and process, both electronically and manually, the information that it collects for the purposes of assessing my application and administering the initiative; and (b) share this information with third parties, as necessary, in connection with the administration of the initiative. I understand that Stop & Help may collect and store images or testimonies provided by myself on the social media of Stop & Help or a third party partner, or any other media outlet. I agree that such images and testimonies can be used by Stop & Help in their absolute discretion for commercial or non-commercial purposes in all and any media, including without limitation, in the internal or external promotional material and publications of Stop & Help. I acknowledge that I may withdraw my consent at any time by contacting Stop & Help at Heather@stopandhelp.ae. However, in the event that I withdraw my consent to the processing of my information, I acknowledge that I may no longer be able to participate in the Stop & Help initiative.
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Application for Grocery Support