Do you require emergency funding assistance from the Virus Economic Relief Fund?

Are you experiencing direct financial hardship due to a virus pandemic? *

Yes

No

Is this virus referred to as COVID-19? *

Yes

No

How would you categorise your need for financial relief from COVID-19? *

Loss of partial income

Loss of all income

Loss of essential services (electrical, water and/or living space)

其他：

As a rating from 0 to least urgent and 10 as most urgent, how would you rate your requirement for financial assistance? *

1

2

3

4

5

6

7

8

9

10

What is the total USD amount you are seeking in this emergency grant? ($1-$5000) *