Please provide a bit of information about yourself to help the panel determine financial need

We recognize this may be uncomfortable, but in order to be as fair as possible for those in need in our community, please be as honest as you can. If the panel has additional questions, we will follow up via the contact info you provide

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* 1. Please provide your contact information

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* 3. What is your typical role?

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* 4. How many 8-hour shifts do you typically work in a week? (at the above restaurant or bar)

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* 5. What portion of your usual shifts are you still working? (at the above restaurant or bar)

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* 6. How much do you typically make in a week? (including tips but after taxes, at the above restaurant or bar)

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* 7. What portion of your typical pay are you still earning? (at the above restaurant or bar)

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* 8. Who is your manager or supervisor? (please include their phone number)

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* 9. What is your current level of need?

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* 10. Please provide a Paypal account if you have one. If not, please provide another method of receiving funds

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