31Oct2024

Making a Difference Building Dreams Creating Impact Saving Lives

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Contacts

HEAD OFFICE:                          548 Market Street,
San Francisco, CA 94104         USA

PROJECT OFFICE:                  Pearl Condo, Bldg A, 15 Fl., Kabar Aye Pagoda Rd.,      Yangon, Myanmar

hello@marykyapfoundation.org

US: +1 415 991 2030                 US: +1 415 799 8282                    MM: +95 9 977 66 7777

* indicates a required field.
This questionnaire is for orphanages enrolled in the #NourishHope2024 campaign, which is dedicated to providing orphanages with rice bags through the Promise of Hope program. Your responses will help us assess needs and prioritize resources effectively. The program enhances health, reduces disease, and fosters a safer environment for children’s growth and self-reliance by ensuring access to nutritious meals and clean water.

FORM 4C

Rice Bags

Step 1 of 2

1) ORPHANAGE INFORMATION:

4) ORPHANAGE LEADERSHIP (Primary people in charge)

The head of the orphanage/caretaker will initiate the form with the support of the Foundation's Orphanage Ambassador representatives (If Required)

1. GENERAL NEEDS ASSESSMENT

2. DISTRIBUTION INFORMATION:

3. ACCOUNTABILITY AND REPORTING

4. COMMUNITY IMPACT

5. PARTNERSHIP AND COLLABORATION

6. BENEFICIARY INFORMATION:

What is the number of children and beneficiary ages the Rice Bags will serve?

7. CURRENT SOURCES FOR RICE BAGS AIDS:

11. CHALLENGES AND CONCERNS:

Prioritize in order into three categories from most important priority, to short term priority, to least important priority for the children to benefit from the Food Aid Program. (Prioritize all that Apply)

Nutritious Food Supplies

Waste Management

Clean Drinking Water

Cooking Equipment

Storage Facilities

Meal Planning Resources

Hygiene and Sanitation Supplies

Food Transport Solutions

Trained Kitchen Staff

Funding

Donor Network

Nutritional Supplements

Waste Management Systems

Monitoring and Evaluation Tools

12. SUSTAINABILITY:

Short-term or long-term sustainability to overcome the threat of Food Security. (check all that apply)

13. OTHER:

Click or drag a file to this area to upload.

The information provided in the above Form for Rice Bags Aids is true and accurate. I accept the Terms and Conditions and Privacy Data Collection Policy. I acknowledge that the relevant committees will only use the information for evaluation. I will provide any character reference upon request and after the initial assessment is completed.

Please kindly send back the completed form as well as attach other useful information to (hello@marykyapfoundation.org or fax at +1415-463-8478)
(eg. organizational mission and objectives, photos, press-release if available)

The information provided in the above volunteer form is true and accurate. I accept the Terms and Conditions, WAIVER AGREEMENT and PRIVACY DATA COLLECTION POLICY.

I acknowledge that the relevant committees will only use the information for evaluation. I will provide any character reference upon request and after the initial assessment.