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Contacts

HEAD OFFICE:                          548 Market Street,
San Francisco, CA 94104         USA

PROJECT OFFICE:                  Pearl Condo, Bldg A, 15 Fl., Kabar Aye Pagoda Rd.,      Yangon, Myanmar

hello@marykyapfoundation.org

US: +1 415 991 2030                 US: +1 415 799 8282                    MM: +95 9 977 66 7777

Step 1 of 2

1) ORPHANAGE INFORMATION:

3) ORPHANAGE LEADERSHIP (Primary people in charge)

# of Employees:

The questions below should form the basis of a comprehensive health check services plan for the orphanage, ensuring that the children's physical, mental, and emotional needs are adequately addressed and monitored. Please include your response in a separate paper. A member of our healthcare professional will be developing and implementing the plan to ensure its effectiveness and relevance.

1. Basic Health Information:

2. Immunization Status:

3. Nutrition and Dietary Needs:

4. Physical Health:

5. Mental Health and Emotional Well-being:

6. Safety and Hygiene:

7. Developmental Milestones:

8. Educational and Social Needs:

9. Resources and Support:

10. Others: (explain in detail)

Click or drag a file to this area to upload.

The information provided in the above Nutrition Assistance Program form is true and accurate. I accept the Terms and Conditions and Privacy Data Collection Policy. I acknowledge that the relevant committees will only use the information for evaluation. I will provide any character reference upon request and after the initial assessment is completed.

Please kindly send back the completed form as well as attach other useful information to (hello@marykyapfoundation.org or fax at +1415-463-8478)
(eg. organizational mission and objectives, photos, press-release if available)

The information provided in the above volunteer form is true and accurate. I accept the Terms and Conditions, WAIVER AGREEMENT and PRIVACY DATA COLLECTION POLICY.

I acknowledge that the relevant committees will only use the information for evaluation. I will provide any character reference upon request and after the initial assessment.