The Spring Initiative Appeals Form
Please use this form to let us know about the challenge you are facing and how you would like us to get involved.
You need to be signed in to Google in order to complete this form. If you do not have a Google account, you can create one. If you are unable to create a Google account, ask someone you know who has a Google account to help you submit an application.
Please note that all questions on the form must be answered clearly. Do take your time to read each question properly and respond well. You will not be able to edit your response after submission.
For additional enquires, contact 08092832745 via WhatsApp for assistance.
* Indicates required question
Record my email address with my response
Are you the applicant or a friend of the applicant?
I am the applicant
I am a friend of the applicant
I am related to the applicant
I don't know the applicant; I just want to help.
What is your name?
What is the applicant's name? If you are the applicant, you can just write your name again, thank you.
Please confirm if you are an adult.
If you are a child, you can still continue with the appeal if you do not trust the adults looking after you. Otherwise, kindly get an adult to fill the form for you.
I am 18 years and over
I am under 18 years old
Does this appeal involve children in need?
Please tell us first about the children involved. How many children (ages 0-17 years) are involved? If no children are involved, write 'None' under the 'other' option.
For each child involved, please provide their full name, sex (gender), date of birth (including year), and the applicant's relationship to the child.
If you do not know this info for any child, please clearly explain why you do not know this information. If no child is involved, write 'N/A'.
What is the problem you are facing?
Kindly provide a detailed response, answering some key questions:
1. When did it start?
2. How has it affected your life?
3. What have you done to help yourself?
In what way do you think Fair Life Africa can assist? You may tick up to three boxes, and you can also go into more detail using the 'other' option.
I need financial assistance.
I need a place to stay for a while
I need to move into a new home
I need medical intervention
I need child protection intervention
I need referrals to health service providers
I need awareness to be raised about my issue to get justice
I need someone to talk to and counsel me
If you need financial support, break it down for us. How much do you need, and what does this amount consist of? If not, write N/A
You will be required to submit receipts, invoices, and other evidences to validate the amount you are requesting.
How urgent is your appeal? If you have a deadline you are working with, use the 'other' option to provide more information, as per the date.
I need a solution immediately
I have a few days to come up with a solution
I can wait for about a week
It's ongoing and stable, I can wait a month or two for a resolution
What is your phone number? We would like to chat with you on WhatsApp to continue the assessment. If you have more than one number, you can write all.
Are you on social media? Help us to identify you faster by sharing your social media handles below.
If you are not on social media, write N/A.
We will not tag you unless you specifically request for us to do so.
We are going to ask a few questions to identify you, the applicant.
First, what is your date of birth. (Please include year of birth)
You will be required to submit a government-issued ID to support your application.
Are you male or female?
What is your marital status?
What is the full name of your significant other or next of kin? Please also provide their phone number so we can contact them if necessary.
Do you have dependents? Tick all that apply
Yes, I am married with children
Yes, I am a single parent
Yes, I look after my siblings
Yes, I am the breadwinner in my family
Yes, I look after my parent/s
Yes, I look after relatives
No, but I recently lost my breadwinner
No, but I am the oldest child and have responsibilities to my family
No, I have people who provide for me/help me
No, I am all by myself.
What is your religious background?
I am Christian
I am Moslem
I am an atheist
Are you receiving support from any religious body or not-for-profit organisation?
Are you employed?
Yes, by a small business
Yes, by a company/organisation
I am self-employed
I am between jobs
I am volunteering/training
Do you have a regular income? If so, please specify your income bracket in Naira. Alternatively, use the 'other' option to say explicitly what you earn each month.
N10,000 - N20,000 monthly
N21,000 - N40,000 monthly
N10,000 - N20,000 weekly
N21,000 - N30,000 weekly
N100,000 - N150,000 monthly
N151,000 - N300,000 monthly
Where do you currently live? Please write out the full address. If you have been at your address for less than one year, please also write the address of the place you lived before.
Who lives with you? Tick all that apply
I live alone
I live with both parents
I live with a parent
I live with my siblings
I live with a colleague/friend
I live with flat/room mates
I live with my child/ren
I live with pets
I live with neighbours
I live with extended family
I live at church
I live with strangers
I live on the streets
I live in a jail/prison
How many siblings do you have? Tell us about each of your siblings (full name, sex, and date of birth). Kindly include information about their educational, marital status, and/or employment status.
What are your parents' names? Please provide the full names of your mother and father (if you do not know this, please explain why). If they are separated, divorced, or belated, please specify.
Are you or anyone else involved in your appeal of ill health (sick)?
If one or more of you is sick, please provide more details below;
Who is sick? What is the illness? When did it start? What treatments have been done? What treatment is still needed? and so on.
If no one is sick, write N/A.
You will be required to submit a letter from your doctor/hospital to confirm your diagnosis and treatment to date.
Is there anything else you would like to tell us that is important to your appeal?
Thanks for your patience in filling out this form. Please note that a submission does not guarantee support, but it enables us to sift through appeals faster and help more people in need.
Before you go, please let us know how you learnt of Fair Life Africa's The Spring Initiative.
A friend/family member told me
I know someone else you helped
I was directed here from your website
I was directed here from your WhatsApp chat
I saw an advert on social media
I searched for you online
Send me a copy of my responses.
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