Charity Request - Application-Africa

Please allot approximately 30-60 minutes to fill out the Charity Request Application below in its entirety. Please note that all the information in application is essential to approving and providing financial assistance. Please keep in mind that the review process for charity requests may take up to 14 days. Please submit this application as soon as you can to ensure that we can provide a request determination for you well before any payments are due. Failure to complete the entirety of the application may delay or cancel the review of your request.

If you need help filling out the application, assistance can be given upon request sent to:

MultiplyTheLoaves@gmail.com

Fill in your name and organization contact information below. Your organization's information will be kept secure. The purpose of this section is to help us know who is requesting assistance and how to contact you.

Applicant's Name*

Title

Organization's Name

Organization's Government ID #

Date Founded

Address or approx. location

City/Town

Country

Phone Number(s)

Email Address*

ORPHANAGE/MINISTRY INFORMATION

Below, list the directors of your organization. Do not list main applicant. Only include the five most important directors (i.e. President, Vice-President, Secretary, Treasurer, etc.) If you have less than 5 directors, just fill in the ones you have. This information will be kept secure. We would only need to contact one of your directors in an emergency.

DIRECTOR 1 INFO

Name

Title

Phone or Email Address

DIRECTOR 2 INFO

Name

Title

Phone or Email Address

DIRECTOR 3 INFO

Name

Title

Phone or Email Address

DIRECTOR 4 INFO

Name

Title

Phone or Email Address

DIRECTOR 5 INFO

Name

Title

Phone or Email Address

OTHER INFO
Any other info you deem important.

Other Info

CHARITY HISTORY

Please answer the following questions regarding your recent history of receiving charity assistance.

Have you been helped previously by Multiply The Loaves, INC?

Have you received assistance from any other church, ministry, or agency during the past 6 months?

If yes, please list the NAMES of the organizations from whom you have received assistance, along with the TYPE of assistance you reveived and the AMOUNT

BUDGET

Next, list the income and expenses for your ORHANAGE/MINISTRY. Use this chart to document all of your income (typical donations) and expenses, not just the ones for which you need assistance. Please only include general operating expenses, not goal operating expenses. For example, for clothing, please only enter an ammount you already spend per month.

MONTHLY INCOME & TOTAL ASSETS
List the monthly income you currently have from the sources listed below, including typical donations. If a particular source does not apply, simply leave it blank or write zero. We understand that most orphanages/ministries cannot predict an exact amount of donations per month. If this is the case with your organization, please just fill in an average month's worth of income.

Source Of Income 1

Income 1 Amount

Source Of Income 2

Income 2 Amount

Source Of Income 3

Income 3 Amount

Other Sources Of Income - and - Their Amounts

INCOME TOTAL

ASSETS

Checking Account Balance

Savings Account Balance

Building and land value (if owned)

Cash Available as of Today

MONTHLY EXPENSES

List the AMOUNTS of your estimated monthly expenses for the categories below. If something doesn't apply, simply write zero.

Check the YES box indicating a need for benevolence assistance for each expense that applies. Please remember to only list General Expenses, not Goal Expenses.

Rent/Mortgage (Amount)

Due Date

Help Needed?

Heating Fuel (Amount) (wood, coal, etc.)

Due Date

Help Needed?

Phone Bill (Amount)

Due Date

Help Needed?

Internet/Data (Amount)

Due Date

Help Needed?

Fuel for auto or to take boda (Amount)

Due Date

Help Needed?

Groceries & Food (Amount)

Due Date

Help Needed?

Children's School Curriculum (if you are a school) (Amount)

Due Date

Help Needed?

Teacher Pay (if you are a school) (Amount)

Due Date

Help Needed?

School Tuition (If you are NOT a school) (Amount)

Due Date

Help Needed?

School Supplies (if you are NOT a school) (Amount)

Due Date

Help Needed?

Clothing and Shoes (Amount)

Due Date

Help Needed?

Hospital/Doctor Costs (Amount)

Due Date

Help Needed?

Agricultural Costs (hired help & supplies) (Amount)

Due Date

Help Needed?

Seeds for planting (Amount)

Due Date

Help Needed?

Repairs & Maintenance (Amount)

Due Date

Help Needed?

Loans & Amounts

Due Date

Help Needed?

Other Expenses & Amounts

Due Date

Help Needed?

TOTAL FOR ALL EXPENSES

BANKING INFO

Please provide your banking/financial institution information below so that we know how to process payment if approved. All bank transfers MUST be transferred to a bank account in the name of the ministry, not an individual.

Name of Orphanage/Ministry

Mobile Phone (for the account)

Bank Name (i.e., Stanbic, Postbank, Centenary, etc.)

Branch Name (Usually the town goes here)

Account Number

Please upload a copy of your government-issued photo ID, or passport, etc. The name must match your application name.

Upload Government Photo ID*

STATEMENT OF VALIDITY OF INFORMATION*

STATEMENT OF VALIDITY OF INFORMATION

I hereby make application to the benevolence committee of Multiply The Loaves, Inc. for charity financial assistance on behalf of the orphanage/ministry I represent. I do verify that the information listed in this application is true and accurate to the best of my knowledge.

I understand that this application is subject to approval of the benevolence committee. I understand that this information is confidential but may be shared with other churches/ministries if a community alliance for benevolence exists or is formed in the future.

I understand that accepting financial help from MTL subjugates me to the U.S.A. IRS regulation and rulings under Section Code 56-304, and I agree to spend any donated funds as a charity and to no personal or private benefit. I also agree to forward receipts for purchases to MTL as often as I am able (when applicable) so as to account for money given. If I am granted assistance, I hereby agree to keep the amount given confidential. If MTL establishes a donation link and fund to help my organization with on-going support, I agree to share it no less than once a week on social media with a picture or video. I will pray and believe God for big things because when Jesus is the source, all things are possible!

IF NOT ALREADY DONE, PLEASE FORWARD ALL OF YOUR ORGANIZATION'S PAPERWORK TO THE FOLLOWING EMAIL ADDRESS WHILE REFERENCING YOUR NAME TO: MultiplyTheLoaves@gmail.com
(or forward through Zoho Cliq)

I agree

After you prese SEND it may take up to 60 seconds to send, depending on the strength of your internet connection. Don't close this window until it displays our Thank You message showing that we've received your application.