Application for Food Aid (For Individuals)

Application for Food Aid (For Individuals)

International Support for the Impacted
This form is to be completed by an individual applying for a food aid grant for his family.

ISI volunteers completing an application on behalf of a group should use the Apply For Food Aid (Group) form.

Our ability to approve your grant depends on our overall funding levels and thus may not happen immediately.
Section 1 - Contact Information
IMPORTANT - The information you provide below MUST match your Government ID.

You will be required to provide your Goverment ID at your local bank to recieve the grant money (if it is approved).

The status of your grant will be communicated via e-mail and text or What's App.
Please provide the name, address and country of the person that referred you to International Support for the Impacted:*
Type name, address and country
Please complete the information below about the applicant (if you have no postal code, type 00000): *
Section 2 - Household Information
What is the total number of people in your household (including yourself)?*
IMPORANT - You must include EACH person that lives in the household INCLUDING yourself in the chart below. Press the "+" button to add more people. *
How much does it cost to buy food for your household for 1 week of meals?*
Please include the amount and name of your currency
Section 3 - Food Emergency Information
International Support for the Impacted provides food aid grants to individuals struggling to feed their families due to loss of work from the COVID pandemic, other health crisis, natural disasters, war, political unrest and government disruption.
Which of the following are making it difficult to feed your family (please check all that apply)?*
Please check all factors that apply:*
Please describe your situation and how the above factors have affected your family's ability to work and buy food for the household.*
Section 4 - Applicant's Declaration
I affirm that I meet the eligibility requirements for emergency assistance described above and that all the information I have provided to qualify for such assistance is complete, correct, and true to the best of my knowledge. Any losses I may have suffered in connection with this emergency have not been covered to date by insurance, funds available through governmental or other agencies, federal or state relief funds, or readily available personal financial resources. I understand that I may be denied assistance if any of the above is false, and that I may be required to repay any assistance that I receive based on false or incomplete information.

Upon request, I agree to provide International Support for the Impacted with evidence of the information I have given on this application. I understand that this application becomes the property of International Support for the Impacted when submitted. I understand that the International Support for the Impacted's annual return is open to public inspection and that, if I receive a grant, International Support for the Impacted may be required by federal tax law to disclose on its annual return my identity and address, the grant amount, and a description of the grant purpose.
Please check the box below:*
Signature*
Type your full name in the box above
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Application for Food Aid (For Individuals)

Section 1 - Contact Information

Section 2 - Household Information

Section 3 - Food Emergency Information

Section 4 - Applicant's Declaration