Your Full Name
Your Email Address
Your Phone Number
How did you hear about us? (Name of referring person) Have you applied for or received funding from New You Foundation previously? YesNo
Amount of funding requested? (Up to $500)
Name of the company that funding will be paid to? (Cannot be an individual's name)
Provide a contact phone number for the company that you are seeking funding for.
Provide a contact person at the company so that we can verify the request.
Date funding is needed by? (Funding can take up to 30 days)
Payment method for funding if approved. (Credit card, check, etc.)
If you're currently behind on the requested bill, please let us know how far behind the payment is, and what your plan is to keep payments current in the future?
Our vision is to is to provide financial assistance to survivors of sexual trauma during times of crisis to allow them to continue to focus on themselves, their families, and their mental well-being. Our focus is to stand in the gap for individuals needing support during a challenging time, help them achieve their goals, and to provide education to reduce the incidence of sexual trauma. Please let us know how your request fits into our vision of helping survivors. In 800 words or less please describe your situation and why you are requesting funding?
