Funding Needs and Community Painpoints

Survey Purpose: To gather insight in preparation for creating a collaborative fund with a mission to support the health and well-being of communities and families across Memphis and the Mid-South most directly affected by the COVID-19 virus by providing assistance to the nonprofits who serve these communities.

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* 1. Organization Name

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* 2. Contact Information

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* 3. How has your ogranization been impacted by the spread of COVID-19 in Memphis and the Mid-South?

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* 4. Esitmated financial impact to the organization

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* 5. Have you requested relief funding from other sources? If, yes, please list the sources and amounts. Please note whether funding is pending or secured.

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