Mamatropolis COVID-19 lifeline recipient questionnaire
To determine eligibility for the micro grant. Please note that this fund is ONLY for parents and guardians of children under 18
Do you have children under the age of 18?
Is there a name you'd like to be referred to as?
Which areas of your life have been impacted by the pandemic?
Loss of job
Loss of freelance work
Loss of access to child care
Direct impact on your health
Sudden need to care for a family member
Are you applying for a micro grant, non monetary aid, or both?
Non monetary aid
What is your ethnic background?
Are you raising your child or children with a partner or co parent whose income can cover child care expenses?
Beyond money, what are other forms of help and support would be useful right now? We are trying to connect people with volunteers who can assist them at this time. Please be as specific and concrete as possible in responding, i.e, “I need to ask a lawyer a question” or “I want someone to teach me a simple work out I can do while my baby is sleeping.”
Even if you are applying to receive funds, you might have a skill or resource that can help someone else out. If so, can you please describe a skill or resource that you'd be willing to "donate" remotely?
Please provide your email address, a name we can address you by, as well as your Venmo or PayPal information below so that we can send you payments and contact you about opportunities
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