From The People To The People
Funding & Assistance Application
Thank you for contacting From The People To The People. This application allows our Vetting & Research Committee to assess your request for assistance in a fair, consistent, and confidential manner. All information provided will be kept confidential and used solely for the purpose of determining eligibility for assistance.
Personal Information:
Full Legal Name:
First Name
Last Name
Date of Birth:
-
Month
-
Day
Year
Date
Current Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Household Information:
Number of Adults in Household:
Number of Children/Dependents:
Please list names and ages of dependents (if applicable):
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Employment & Income Information
Employment Status (select one):
Employed
Self-Employed
Unemployed
On Benefits
Other
Employer Name (if applicable):
Monthly Income (approximate):
Other Sources of Income (if applicable):
Financial Situation:
Please describe your current situation and why you are requesting assistance:
Type of Assistance Requested
Type of Assistance Requested
Rent / Housing Support
Utility Bills
Food / Essentials
Emergency Assistance
Other
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Amount Requested: $
What will this funding be used for specifically?
Monthly Household Expenses
Rent/Mortgage:
Utilities:
Internet/Phone:
Vehicle Payment:
Insurance:
Childcare:
Other Monthly Expenses:
Have you applied for or received assistance from another organization regarding this request?
Yes
No
If yes, please explain:
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Supporting Documentation (Mandatory)
Please attach or provide the following:
Proof of overdue bills or notices
Bank statements (up to 3 months)
Proof of income
Eviction or disconnection notices (if applicable)
Any additional supporting documents
Government-Issued Photo ID Provided
Driver's Licence
Provincial ID
Passport
Other:
Other
Who should payment be made to?
Name:
Account Number (if applicable):
False or misleading information may result in the denial of assistance and may affect
eligibility for future programs.
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Declaration & Consent
By signing below, I certify that all information contained in this application is complete and accurate to the best of my knowledge. I authorize From The People To The People to verify the information provided where necessary for the purpose of assessing my application. I understand that submitting this application does not guarantee funding or assistance. I also understand that knowingly providing false or misleading information may result in the denial of my application and may affect future eligibility for assistance.
Applicant Name:
Signature:
Date:
-
Month
-
Day
Year
Date
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Office Use Only
Application Number:
Date Received:
-
Month
-
Day
Year
Date
Received By:
Case Number:
Application Status
Complete
Incomplete
Under Review
Additional Information Required
Date Reviewed:
-
Month
-
Day
Year
Date
Board Decision
Approved
Denied
Deferred
Amount Approved: $
Director Of Vetting & Research:
Signature:
Date:
-
Month
-
Day
Year
Date
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