One City Emergency Resources / Check-In Needed (COVID-19 pandemic) Recursos de emergencia necesitados One City (Pandemia COVID-19)

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Has your employment been financially impacted since our (temporarily) school closure on March 13th, 2020 (ie, reduced work hours or total loss of income)? / ¿Su empleo se ha visto afectado financieramente desde el cierre de nuestra escuela el 13 de marzo de 2020 (por ejemplo, reducción de horas de trabajo o pérdida total de ingresos)

Yes, my employer reduced my work hours &/or I have since lost my job. / Sí, mi empleador redujo mis horas de trabajo y / o he perdido mi trabajo desde entonces

No, since I'm able to work from home while earning my same paycheck or more. / No, ya que puedo trabajar desde casa y ganar mi mismo sueldo o más.

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As of today, do you require emergency, financial assistance to pay bills, childcare, food, basic supplies, or other needs? PLEASE EMAIL COPY of bill to Marilyn Ruffin at mruffin@onecityschools.org (Don't forget to refer to Madison's Resource page for other programs and services provided in our community): bit.ly/MadisonCOVID. / A la fecha (03/25/20), ¿Usted necesita asistencia financiera de emergencia para pagar facturas, cuidado de niños, alimentos, suministros básicos u otras necesidades? (No olvide consultar la página de Recursos de Madison para otros programas y servicios provistos en nuestra comunidad)

Yes / Si

No / No

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Please explain your most pressing needs for next 15 days thru May 15th (financial or mental health-related). If bill related, PLEASE send a separate email to Ms. Marilyn: mruffin@onecityschools.org. We want to hear from ALL of you. / Por Favor Explique sus necesidades más apremiantes para los próximos 10 días hasta el 3 de abril (relacionadas con las finanzas o con la salud mental). También puede enviar un correo electrónico por separado a la Sra. Marilyn: mruffin@onecityschools.org. Sin embargo, si todo se encuentra bien en este momento o le gustaría ayudar de alguna manera, por favor háganoslo saber también. Queremos saber de TODOS ustedes. * Tu respuesta *

Do you have access to internet &/or have access to a computer/tablet for your child to use? *

Yes, I have internet access at home. / Si, Tengo acceso a internet en la casa.

NO, I do not have internet access at home. / NO, no tengo acceso a internet en casa.

Yes, I have computer / tablet/ Ipod for my child to use

NO, I do not have a computer / tablet / Ipod for my child to use. (PLEASE CONTACT LaTisha White at 484.531.4320 for assistance)

Other:

Required

Social Distancing MENTAL HEALTH check-in. How are you doing? *

I'm doing great!

I am okay, for now.

Things are tough but I'm hanging.

I'm starting to struggle.

I'm having a hard time and wouldn't mind if someone would reach out to me

I'm in a bad place right now. I really need someone to call me ASAP

Other:

Required

(4/30/2020) We have home made MASKS available. If you're interested in picking up one for yourself &/or for your family, please state YES and HOW MANY. * *

Your First and Last Name / Tu nombre y apellido* *

Name of your child(ren) enrolled at One City during 2019-2020 school year (Must be a current One City family to be eligible for assistance) *

Your best contact phone number / Su mejor numero de teléfono de contacto

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