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 participating in the #NourishHop2024 campaign, which is dedicated to providing children with food plates and 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 4B

Food Plates

Step 1 of 2

1) ORPHANAGE INFORMATION:

3) ORPHANAGE LEADERSHIP (Primary people in charge)

4) CLASSIFICATION OF ORPHANS/NON ORPHANS:

5) ENGLISH LANGUAGE SKILLS AMONG LEADERS:

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

1. OPERATING DETAILS:

2. FOOD STORAGE AND HANDLING:

3. BENEFICIARY INFORMATION:

Below is the age range of children the orphanage serves. Briefly explain the dietary restrictions or preferences among children (if any).

4. CURRENT FOOD SOURCE:

5. FOOD AID PROGRAM NEEDS:

6. SPECIAL VOLUNTEERS ON SITE:

Staffing Volunteers for food preparation and food safety specialist requirements at the Orphanage Site:

7. IMPACT AND OUTCOMES:

8. PARTNERSHIP AND COLLABORATIONS:

9. CHALLENGES AND CONCERNS:

10. ADDITIONAL COMMENTS:

11. OTHERS:

The information provided in the above Food Plates Relief form 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.