SAFE IN HERALD5safe
NEEDS BASED APPLICATION
DATE________________________
RECIPIENT’S NAME____________________________________
ADDRESS_____________________________________
______________________________________
TELEPHONE______________________________________
EMAIL____________________________________________
NOMINATED BY________________________________________
TELEPHONE___________________________________________
REASON FOR GIFT_____________________________________
________________________________________________________
APROXIMATE NEED AMOUNT_________________________
SMALL GROUP & LEADER
_______________________________________________________
CRITERIA FOR ELIGIBILITY:
EXAMPLES OF ELIGIBLE NEEDS: