Application for Assistance ← BackThank you for your response. ✨ Full Name(required) Home Address for last 3 years (required) Telephone(required) Email(required) Marital Status: Spouse full Name: Number of members in your family: Number of dependents: Age of all dependents living with you: Education Level: 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: 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: Household Monthly Income – provide details: Household Monthly Expenses (Rent, food, transportation, medical expenses, etc.) – provide details. How much financial assistance are you and anyone in your household getting from any other organization? How much financial assistance are you and anyone in your household receiving from the government agencies? Total financial aid that you are requesting?: Number of months you requesting financial assistance Tell us in full detail and provide backup support why you need financial assistant?(required) What efforts are you making with details to improve your current situation?(required) 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) Please provide full names, phone numbers and email address of at least 3 personal references and your relationship with each personal references(required) Do you have any felonies or misdemeanors on your records? Please explain(required) Please send via US mail or email your Photo ID , SSN Card and all supporting documents to the ybc@ybcfoundation.com SubmitSubmitting form Δ Share this: Share on X (Opens in new window) X Share on Facebook (Opens in new window) Facebook Like Loading...
YC Foundation 