Application for Assistance Go backYour message has been sent Full Name(required) Warning Home Address for last 3 years (required) Warning Telephone(required) Warning Email(required) Warning Marital Status: Warning Spouse full Name: Warning Number of members in your family: Warning Number of dependents: Warning Age of all dependents living with you: Warning Education Level: Warning Employment information. Provide detailed of each of your employer names, address, your supervisor’s name, phone number, how long have you been working, current pay rate, daily work hours, weekly/ monthly total work hours and all other support information: Warning Employment information for spouse and all household members: Provide detailed of each of your employer names, address, your supervisor’s name, phone number, how long have you been working, current pay rate, daily work hours, weekly/ monthly total work hours and all other support information: Warning Household Monthly Income – provide details: Warning Household Monthly Expenses (Rent, food, transportation, medical expenses, etc.) – provide details. Warning How much financial assistance are you and anyone in your household getting from any other organization? Warning How much financial assistance are you and anyone in your household receiving from the government agencies? Warning Total financial aid that you are requesting?: Warning Number of months you requesting financial assistance Warning Tell us in full detail and provide backup support why you need financial assistant?(required) Warning What efforts are you making with details to improve your current situation?(required) Warning Are you a US citizen or permanent legal resident? Provide backup support documents. If no, please explain your status below and provide a support document(required) Warning Please provide full names, phone numbers and email address of at least 3 personal references and your relationship with each personal references(required) Warning Do you have any felonies or misdemeanors on your records? Please explain(required) Warning Please send via US mail or email your Photo ID , SSN Card and all supporting documents to the ybc@ybcfoundation.com Warning. SubmitSubmitting form Δ Share this: Click to share on X (Opens in new window) X Click to share on Facebook (Opens in new window) Facebook Like Loading...
YC Foundation 