FGNP- Community Need Based Fund Application

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Mentors in our programs become eligible for need-based assistance based on the applications provided below. This support is designed to help reduce financial barriers for mentors who are actively contributing to their communities and investing in the success of younger students.

What is your name? *

Please provide an email or phone number for us to contact you: *

Do any of the following apply to you or your immediate family? (Check all that apply)
*

I (or a sibling) qualify for free and reduced lunch at school / Yo (o algún hermano/a) calificamos para recibir almuerzo reducido gratuito.

I (or my parents) have struggled to pay rent or have sufficient money for food or basic medical care in the last 6 months / Yo (o mis padres) han tenido dificultad para pagar la renta o tener dinero suficiente para comida o atención médica básica durante los últimos 6 meses.

A member of my family qualifies for TANF / Un miembro de mi familia califica para TANF

A member of my family qualifies for SNAP / Un miembro de mi familia califica para SNAP

A member of my family qualifies for Medicaid / Un miembro de mi familia califica para Medicaid

Having enough income to take care of basic households needs is a regular source of stress for me or for my parents / Teniendo suficientes ingresos para hacerse cargo de las necesidades básicas del hogar, es una fuente habitual de estrés para mí y mis padres.

I or a member of family member do not have medical insurance

Other:

Required

Is there anything else you’d like to share with the CAN Team about how we can support you or your family?

Submit

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