Request edit access
Loan Payment Assistance Application
If you are unable to make your full loan payment because of the impact of COVID-19 (i.e. job loss, reduction in hours, etc.) you can apply for loan payment assistance. We have limited funds to support this so we are asking everyone who is able to make their payment without help to do that. If you are unable to make your full payment because of the impact of COVID-19 you can complete a brief application stating how much you can pay and what you are asking us to cover. We will contact you to discuss your request. To apply for support, fill out this form. If you have questions, contact Paul Yates at (305)546-3989.
What is your phone number?
Are you a Client Partner in Good Standing (this means you have made your payments in 2020 before COVID-19)?
Please describe why you need assistance with your loan payment.
What is your loan payment amount?
How much of your loan payment can you pay?
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of The Fountain Fund.