1.

FAMILY RECORD

A family record is an individual record for each Unbound member that is entered and
maintained in Portal. Family records serve three purposes:

1. Unbound-Kansas uses this information to create profiles to share with potential and
existing sponsors
2. Projects can use family records for their own record-keeping purposes.
3. Updated family records are used derived from the Unbound Portal.

Kansas Use: Philippines Projects must submit a family record to Unbound-Kansas for each
sponsored member available for sponsorship. The family record is used to create a story that
provides potential and current sponsors with basic information about the sponsored member,
their family and life. It is the first step in introducing the sponsor to their sponsored friend and
forming their sponsorship relationship. Please see the appendix for an example of this story
compared with a family record as submitted in Portal. The profile developed from the family
record is often the only information that a potential sponsor sees when making the decision to
sponsor an individual. Potential sponsors have many profiles from all over the world to select
from and they use the information in the family record story to make their final decision. It
remains the only information a new sponsor has until regular correspondence is established. It is
essential, therefore, that the family record provide a complete, detailed description of the child
or elder, his or her life situation, personal qualities, future plans, etc.

Project Use: The family record can also serve as a tool for projects to track information for
sponsored members. In addition to the standard fields that are available, projects can create
custom fields based on their needs.

When a record should be created: Family records should be created and submitted to
Unbound-Kansas when submitting new individuals as candidates for sponsorship (replacement
or growth records).

Social Development workers or the Communications and Records staff in charge using their
access to Portal does the process of encoding and filling up of Updated Family Record forms
and its needed information.

The Communication and Records Department staff is responsible for the final checking of the
authenticity of the information gathered, documents presented and the completion of
requirements. It is also essential to ensure that qualifications set by the projects were met.

Incomplete records, records with lacking data or supporting documents; or records containing
contents for further verification will then be returned to subproject; the records will be qualified
for encoding once data needed has already been re-submitted or completed.

The subproject informs applicants of their current status in Unbound recruitment. Disqualified
applicants due to incomplete requirements can still re-apply but will need to go back to the first
process of recruitment. (Please refer to sponsorship manual on Selection for sponsorship)
Project Family Records for new applicants are created in the Unbound Portal when the family
applicants for sponsorship have successfully passed the set qualifications, obtained the required
documents and completed the application process.

The Unbound Portal system will automatically assign a “record number” for each encoded
record, once it is in the “Pending project approval status”. The CaRD Head and card staff
assigned will carry out the final review of the said record from “Ready to submit” status if
records is scheduled to send in a given time and will then be submitted to Unbound Kansas
with “Pending Kansas Approval status” as candidate for sponsorship.

The designated CHILD ID is the indicator that new or replacement records had been successfully
submitted and is already included in the Project Demography as Available Records for
sponsorship

A folder will be created for each individual applicant containing the printed family record,
photo, and identification document that will be kept in the Sub Project office.

Records send-off: Project sends the processed digital family records to Unbound Kansas.

When should a record be updated? The Project’s Communications and Records Department
received a request from Unbound Kansas for a record to be updated if new information is
needed for a current beneficiary (update requests). Subproject may also update records as
needed whenever updated information for beneficiaries is available even if Kansas or the
coordinating unit does not request an update.

Data Quality: It is essential; therefore, that the family record provides a complete, detailed
description of the child or elder individual, his or her life situation, personal qualities, future
plans, etc. If records are not unique, potential sponsors may have doubts about Unbound
programs and the existence of the child, elder or vocation.

Review of the recruitment process for new and replacement records should be included in the
Subproject plan every six months to improve the Family Records quality and efficiency of
submission to the Unbound Kansas Team.

To provide quality Family records, Projects have their unique process for recruitment of
potential sponsored children, elders, youth or vocation. In this process project staff gathers
accurate, reliable, and detailed information on the potential applicants and fills out the essential
needed details in the Family Record Forms.

Interview: Project must use the most up-to-date Unbound-Kansas approved family record
template when completing family records (see appendix for instructions on locating and
downloading these templates.

The child with his/her parents/guardian, elders with his/her official guardian is both required to
be present during the interview.

An older sibling is considered at times but may not be able to provide specific information like
details on sources of income, living condition, and goals of the family.
1.1 Records Allotments and Submission

The enrollment process for sponsorship for new and replacement records should be included in
the Sub Project monthly Calendar to better the Family Records quality and efficiency of
submission to the Unbound Kansas Team.

Social Development Worker must submit Family records for replacement or growth in a monthly
manner so that processing and submission of records will be timely.

Record Allotments (APP Level)

A replacement record is required for every retirement of sponsored members.

Project has the option to open the slot for growth with Kansas approval on replacements record
with a smaller number of sponsored members at their subproject or area or newly opened area
for recruitment.

Project Coordinator and/or his/her designated staff should regularly monitor the records
allotted information in Portal to know how many records can be submitted for the 6-month
period at any given time (see the Portal User Guide for more information).

Records should be submitted gradually throughout the semester as they are completed and as
records become available. This allows Unbound-Kansas to present potential sponsors with
records from all geographic regions, ages and genders at sponsorship campaigns.

Projects should anticipate ahead and include in the annual program plan preparation the
number of graduates for retirements every school year so they can plan ahead the replacements
in due time for Family records timely submission.
Social Development workers must ensure that whenever a sponsored member gets retired from
the program i.e. (died, graduated, economically improved, working, discontinued studies,
started a family, leave the program, voluntary exit from the program a corresponding
replacement record is required for every sponsored member retirement.

New and replacement records can be put on hold/suspended due to unforeseen situations.

1.1.1 Replacement/Growth Records

 Unbound Philippine Projects receive a communication from Unbound-Kansas Project

Specialists for the allocated replacement and/or growth records to each project prior to
the six-month period (January-June and July-December).
 “Replacement” records refer to records that may be submitted for beneficiaries
who are retired within the time period. This does not include retirements for no
letter, no photo, or no update request (initiated by Unbound-Kansas for non-
compliance).
 “Growth” records refer to records that may be submitted in addition to the
number of individuals that are retired.
 “Adjustment” records refer to records that were transferred from those allotted
during previous semesters, but not submitted during that time period due to
external or unexpected circumstances.
  “Inter-Project Transfer” records refer to sponsored members transferring from
one Project to another Project decreasing or increasing its population
subsequently.

 Replacement and growth records may be submitted for the following (contact your
project specialist for exceptions to the age requirements in special circumstances):

 Child 0-12 years of age

 Elder age 60 or older

1.1.2 Record Types

There are three types of family records in Portal: Child, Youth, and Elder. Please see the
guidelines below to determine which type should be used:

Beneficiary Category Family Record Type

Child 0-12 years Child Family Record

Youth 13 years and older Youth Family Record

Elder age 60 or older Elder Family Record

Special needs are defined by Unbound -Kansas as someone who will not be able to care for his
or herself long-term. Projects are welcome to submit records for these individuals as long as the
individuals are within the normal age range for a new child or elder. Exceptions can be made for
special cases, however, these exceptions will be considered based on whether sponsorship will
help the individual achieve a specific goal, as with all other applicants. Having special needs
alone does not constitute a reason for an exception.

The questions below help potential sponsors to understand how sponsorship will help the
family. It is essential to include detailed responses in Portal to the following questions for
special needs records:

● Does this person have any limitations that will prevent them from fully caring for
themselves long-term?
● Could you describe the specific limitations and challenges he/she has according to the
professional psychological report or medical diagnosis?
 ● Have you considered an educational plan or occupational therapy that will help this
person to become self-sufficient? If so, could you describe the plan?
● How is this person and family going to benefit from the sponsorship program?

Special Needs Category Type of Family Record

(PWD, with Chronic Health to be used
Condition)

Ages 13-20 Child Family Record

Ages 21 and older Elder Family Record

Important Tips and Reminders

The family record is designed to tell a story. The spaces provided for additional
information about the individual are very important and must be filled in completely
with as much detail as possible (within the character limit of the field). Unbound-Kansas
uses the information provided to create paragraphs for the potential sponsors to read. If
there is not enough unique information about the individual, all the stories seem the
same.

1.1.3.1 Entering Names in the Family Record

It is especially important that the name that is entered on the family record be the complete and
correct name of the individual. It is highly recommended that the Social Development worker or
The Communications Staff entering the names in Family Record must meticulously utilize the
attached Authenticated Birth Certificate, valid ID indicating complete name and birthday of the
applicants as the basis for Authenticity of applicants and their families’ identity.

The following instructions explain how names should be entered on family records in order to
help the sponsors understand the name of their sponsored friend.

First Name - This is the first given name of the person.  

Example 1:  Juanito  Reyes   Santos  

             (First)   (Middle)  (Last/Surname)

Example 2:  Magdalena    Aguilar  Dela Cruz___

(First)             (Middle)    (Last/Surname)

Please, do not use an initial (ex. M. DelaCruz) for the first name.
Middle Name - Not everyone has a middle name, and it is acceptable to leave this space empty
if the person does not have a middle name. If the person has a middle name, please type their
complete middle name and not an initial. 
Last Name/Surname/Family Name - Most sponsored members have at least one last name
(also known as a surname or family name), though some may have more than one last name or
no last name. In any case, it is important that the last name of the child or elder appear correctly
on the family record. Please do not abbreviate or use an initial for a last name.

Example 1: A person with one last name.

Juanito   Reyes _ Santos  

(First)   (Middle)      (Last/surname)

Example 2: A person with two last names. 

Nenita Gregorio    Rojas Francisco

(First)   (Middle)  (Last/surname)

The names of sponsored members appear in the Unbound-Kansas database and in Portal as
they are entered on the family record. Last names are used for record-keeping purposes only
and will not be shared with the sponsors. On Portal reports, the names are sorted and
alphabetized by the last name. If the person does not have a last name, he/she appears on the
list according to his/her first name. If the sponsored member has two last names (for example,
‘Rojas Francisco), his/her name will be alphabetized by the first name.

Likes to be called

This field should only be completed if the person has a nickname that he/she is commonly
called by many people, even outside of the family; for example, if Rizal goes by Pepe or if John
Paulo is commonly called JP. The “likes to be called” name is printed on the record and photo
that are shared with new sponsors (for example, “Francisco (Francis)”), so we request that you
not include names that are only used by the family (for example, “Skinny” or “Little princess”). 

If the person is always called by his/her first name, the “likes to be called” field should be left
blank. Listing the first name in this field will cause a duplicated name to display on the photo
and family record that sponsors see; for example, “Maria (Maria).”

2.1.3.2 Photos submitted with Family Records

Subproject should upload photos that are not more than three months old at the time it was
taken for record submission. Photos for Family records must follow the same guidelines as of
the Digital Photos. (Please digital photo guidelines.)

3.1.3.3 Additional Details 

The family record is designed to tell a story. The spaces provided for additional information
about the individual are important and should be filled in completely with as much detail as
possible (within the character limit of the field).
Creator of the Family record in the project highly encourages all the project staff involved in the
recruitment process to gather as many specific details about the applicant so that the family
records could be accomplish in a creatively and unique manner that would provide a clear and
vivid representation of the child, elder vocation applicant and their family’s situation, dreams
and aspirations.

Unbound-Kansas uses the information provided in the Family record submitted by the Projects
to create paragraphs for potential sponsors to read. If there is not enough unique information
about the individual, all the stories seem the same. 

Please pay careful attention to the fields described below. These fields allow the story of the
individual to be told and for the sponsor to learn about his/her unique interests and personality.

“Additional information (personality etc.)”: This field should be used to describe what makes
the individual unique. Some ideas of things that could be shared for each age group are:

 Babies and toddlers: For infants and very young children, share observations about their
emerging personality and behavior provided by their caretakers.

 What skills are they currently developing?

 How do they interact with others?
 Are they outgoing or reserved?
 Are they laid-back or energetic?
 What makes them smile?
 What calms them when they are upset?

 School-aged children: For children, who are able to respond to questions, allow them to
share their interests and personality directly? If the child is shy or otherwise unwilling to
share, observations provided by caretakers are acceptable.

 What games do they enjoy playing?

 What is their favorite meal or favorite color?
 What do they like to do when spending time with friends or family?
 Do they have their favorite song, music, its title and why?
 Favorite food, artists, books, toys, cartoon characters, TV shows and why? 
 Any pets?
 Project staff could also ask the guardian or family members a brief description of the
applicant personality. Favorite subject or teacher?
 Favorite activities of the child?
 IP’s community and their unique cultural practices/activities in their communities

 Adolescents: Teenagers should provide their own response to questions related to their
personality and interests.

 What adjectives would they use to describe themselves?

  How do they enjoy spending free time?
 What do they like to do when spending time with friends or family?
 What is their favorite thing about themselves?
 What are their dreams for the future?

 Elders: Elders should provide their own responses to questions related to their
personality and interests.

 What makes them proud?

 What lessons they have learned over the years that they would like to share with
others?
 What challenges have they faced and/or overcome?
 Do they have opportunities to socialize with friends and family? If so, what do they
enjoy doing together?
 What is their favorite meal to prepare or eat? 
 Do they have their favorite artists, song, music, its title and why? Any pets? 
 Project staff could also ask the guardian or family members a brief description of the
applicant personality.

Note: Avoid putting details on the applicant’s physical appearance or describing them.

Education:

 Child (12 or younger): Focus on the child's academic and extracurricular interests. A child
is not expected to have an established career path in mind, but do provide their
aspirations for the future if they are shared. Additional valuable information might
include the child's social experience (For example, do they play with friends at recess,
what game do they usually play? Do they help their teacher collect papers? Are they a
member of any school organizations or clubs?) or a description of the schooling
environment (such as the condition of the building, the quality of the curriculum,
Academic inclination, achievements, grading remarks, attitude towards studies, number
of subjects.  etc.)
 Youth (13 and older): Focus on the youth's higher education plans and/or career goals. If
the youth is not currently attending school, an explanation should be provided along
with a plan for when they will return. Even if a youth is out of school at the time, please
share favorite subjects, career goals, and other education information as applicable.

Health:

If the health of the applicant is not good, please be as specific as possible when providing
details about why his/her health is fair or poor. For example, instead of writing, “She has
cerebral palsy” or “She has cerebral palsy. She can’t do anything,” more specific details should
be shared like, “She has cerebral palsy. She is unable to speak and lacks muscle control, so she
requires assistance to meet her daily needs. She communicates with her family using hand
gestures and eye movement."

“What makes this family unique?” This field should be used to describe what makes this
family unique. Some ideas of things that could be shared are:

 Traditions: Do they observe any religious, cultural, practices or familial traditions? How
are birthdays and holidays acknowledged in the home? Do they worship or pray as a
family? Do they prepare certain meals for special events?
 Activities: We may include the activities that the family does together, their favorite
meals, and favorite bonding activity.
 Values: What positive character traits or behaviors are displayed and/or encouraged in
the home? What expectations have the parents set for their children?
 Daily life: How does the family divide household labor? Are there any tasks that they
perform together (such as gathering firewood)? What is their typical routine? Do the
parents help the children with their homework? Do older siblings or other families assist
with childcare? Do they share leisure time? If so, what activities do they enjoy as a
family?
 Relationships: How do the family members relate to each other? Do they communicate
openly? Are there extended family members living with them? Do they treat each other
with kindness and respect? How do they manage conflict when it arises? Are they close
with extended family, such as grandparents or cousins?

Source of income: Avoid responses that only list which family member(s) support the family
financially. Instead, share details about their employment and earnings, such as the typical tasks
completed for work, whether the position is permanent or temporary, if the earnings are fixed or
vary, etc. Is there anyone who helps them financially? Are they supporting anyone other than
immediate family? Does the parent help the children with their school work? How do they
describe their family?

 “Additional information about the living situation and/or community”: This field should
be used to describe what makes their situation unique. Some ideas that could be shared:

 Home: 

 Is the home rented or owned?

 Do they live with extended family? If so, does the family have a separate living
space?
 Are expenses like food and utilities shared?
  Does the home have sufficient space for everyone that lives there?
 Do they have separate spaces for sleeping and cooking?
 Are the furnishings adequate?
 Is the home structurally sound?
 Are there issues due to poor insulation or ventilation?
  Do they have access to a latrine?
 Accessibility of family's home to community facilities instead of basic necessities?
 Geographic description of the community i.e. (Upland, mountainous, flood prone,
congested, near the shore line etc.)
  Cooking and water supply: please provide more than a Yes or No response. For
example, for cooking, provide more details like, “gas stove.” For water, provide
more details like, “They get water from a local aqueduct.”

 Community:

 What is the quality of the infrastructure, such as roads, utility services, etc.? 
 How far is the community from the nearest healthcare provider or market?
 How many schools are in the area, and how many grade levels can be completed
without traveling to another community for school?
 How do they travel into or out of the community?
 Is public transportation accessible?
 How do the neighbors typically interact with each other?
 Does the community have communal spaces like parks?
 Are there any festivals or traditions observed in the area?
 Does the family feel safe in their community?
 Are there many employment opportunities available?
 What types of work are most o common in this area?
 What is the typical climate?
 Does it affect the family's daily life or economic o opportunities?
 Is the family from the area? If not, what brought them to their current
community?

“Child/Youth's Unbound goal" and "Family's Unbound goal" These fields should be used to
describe the goals that the sponsored member and his/her family will work to accomplish
through their participation in the sponsorship program. Goals should be defined in a way that is:

 Specific - The goal should be clearly defined. Social Development workers shall
monitor the sponsored members personalized goals using their My Goal booklet.
 Measurable - Progress towards the goal should be able to be monitored.
 Attainable - The child/youth or family should be able to set small steps or
achieve progress towards the goal, even if the final goal may not be immediately
achievable.  

Goals can change over time, and it is okay if the final goal of the sponsored member does not
match the original goal.

Below are some ways to talk with families about the Unbound goal fields. If a child is unable to
express his/her own goal, it is perfectly fine for the mother or other guardian to answer on
behalf of her/his child. Here are some sample questions below.

Guide Questions can be:

 What do they look forward to achieving through the help of the program?
 Are there any talents/ skills they want to acquire or develop?
 Are there any specific learning/ values/ new things they want to gain?
  Are there any interests/ fields they want to participate in? Are there any
experiences they want to have that maybe they didn’t have before?

Child goal:

 (If the child is older):

 What do you want to achieve in life that Unbound can help you accomplish?
 What do you want to do in the future?
 What kind of person do you want to be? What do you think you can accomplish with
Unbound’s help?

 (If the child is younger): these questions can be directed to the mother, father or
guardian:

 What do you hope your child will be able to achieve with Unbound support?
 How do you hope your child’s life will be different in the future?
 Can Unbound help?

Family goal:

 Why does your family want to be part of Unbound? 

 How would you like your life to change/improve with Unbound’s help? 
 As a family, what is your dream or hope for the future? How do you think Unbound can
help?

A staff member might use a series of questions to try to determine the goal without ever even
using that word. This could also apply to the family goal. Ultimately, the purpose of the goal
fields on the record is to know why a child or family wants to be part of the program and to
begin to understand how Unbound can best support them. Below are some scenarios. They are
only examples, but it is important to recognize that, in the majority of cases, these fields require
a conversation with families.

Example 1 (child goal):

Staff: What do you want to be when you grow up? What steps will you take to accomplish your
goal?
What kind of person do you want to be? Is there something you want to do in the future or
something you would like to accomplish?
Child: I want to be a good person. I want to get married. I want to go to school.
Staff: Why do you want to go to school?
Child: So I can help my family.
Staff: How will you help your family?
Child: If I go to school, I can get a professional job and earn money. I could be a teacher.
Staff: It sounds like you would like to graduate from school and maybe become a teacher. Is that
true? That is a great goal. I believe you can do that and I think Unbound could help.

Example 2 (family goal):

Staff to Mother: Why do you want to be part of Unbound? How would you like your family’s
situation to change or improve?
Mother: I want to have food and clothes for my children.
Staff: How will that help your children?
Mother: Sometimes they are hungry at night and it gets very cold here.
Staff: Do you think Unbound can help with that?
Mother: Unbound could give us food and blankets.
Staff: Is there a way to make sure that your children are always fed and warm?
Mother: If I made more money, I could buy more food and we could fix the holes in the house.
Staff: In what ways/means you could make more money or income?  Would you like to grow
your business or repair your home in the future?
Mother: I would like to fix my house.
Staff: That sounds like an important goal for your family. I believe you can fix your house and
Unbound can help.
 

Vocation Family Record

It is a special family record form designed for vocation candidates. It consists of two pages, the
first page contained candidate personal information, second of which is a personal introductory
letter from the candidate describing his or her background, community service commitment,
hopes and needs it either contained their vocation story.

Procedures

 The project must submit a seminarian or sister candidate family record with the
candidate’s personal letter and one photo.
 Vocations records must be sent as Microsoft Word or PDF files to the email address
CSNewFamRec@unbound.org. We are unable to accept family records submitted as
a .JPG image.
 There should be only one family record per Microsoft Word document or PDF file.
 All digital photos for beneficiaries should be uploaded through Portal. Please see the
Photo Page Section of the Portal User Guide for more information.

Process of Recruitment/Selection of Sponsored Vocation Candidates

 The seminarians and/or sister candidates selected for sponsorship will be well
established in their vocational journey. Seminarians should be at least on his first year in
theology or last year in the minor seminary. Minor Seminarians, may be enrolled in the
child sponsorship program, and are not eligible for the vocation sponsorship program.
 Sisters at least after her novitiate formation or on her Juniorate stage of formation.
 Seminarians and sister candidates selected for sponsorship should have clear economic
need and a demonstrated desire to provide pastoral service to underserved and poor
communities as a part of their religious vocation.
  The candidates selected should be in real need, lacking of resources and means to
support his or seminary formation either by his or her congregation. The vocation
sponsorship program is meant to help vocation candidates who might otherwise be
unable to pursue their chosen vocation within the Church.
 Applicants could be referred, walk-ins as long as they met the required qualification and
seen with commitment and desire to be in the sponsorship program.
 Prior to filling in the required family record to be submitted to Kansas a candidate
should undergo an orientation about the program, process of sponsorship and the
requirements need to accomplish upon sponsorship.
 A candidate who agreed and willing to commit with the program policy may proceed
into accomplishing the family record to be submitted to Kansas.
 Taking of candidate’s photo
 Signing of Vocation Sponsorship Agreement.
The vocations sponsorship agreement describes the commitments of Unbound and the
commitments of the vocation candidate.
 The agreement should include the project’s commitments (including the monthly
financial support that will be provided) and the candidate’s commitments (including
requirements for correspondence, financial reporting, and pastoral service).

Retirement of Seminarians and Sisters

 Sponsored members in the vocations program should be retired from the program
within three months after they are ordained or take their final vows.
 Sponsored Vocation upon assessment and intervention but still found to be unfaithful to
his or her commitment to the sponsorship may result to his or her retirement.
 Sponsored Vocation discontinued his/her formation.

Types of Regency

1. Forced Regency- a form and recommended to discontinue his or her formation as

discerned not suited to a specific institution or congregation. Forced regency may result
to dismissal.

Dismissal from the formation resulting to non-acceptance to any congregation or

religious institution.
2. Guided/Formative Regency- a form and recommended to discontinue his or her
current formation and advise to undergo a special program or formation for his/her
growth.

3. Personal Regency/Unguided Regency- a personal desire of the form and to

discontinue his/her formation for some reasons like discernment. However, it must not
exceed for more than two years.

Notes:

Forced Regency may not result to early retirement if it is not a dismissal case and the form and
may continue his/her formation to the other congregation or institution.
Guided/Formative Regency could not be a reason for an early retirement as long as the
sponsored vocation has a constant communication with the project staff to give personal
updates and comply all the required requirements.

 Unfaithful Commitment to the Sponsorship Program Policy resulting to in activity and

non-participation.
 Personal expression and desire of withdrawal from the sponsorship program.
 Incessant transfer from one congregation to another up to three times.

Note: Continuous transfer from one congregation to another resulting to prolong his/her
formation could be a reason for an early retirement. However, it must undergo and subject for
an assessment.

1.1.4 Consent

Sponsored families must have a choice on whether or not their images and stories appear in
Unbound publications and promotional materials, including the Unbound website and other
digital channels. The Unbound website is used in both communication efforts to current
sponsors and invitation for sponsorship with new sponsors. 

It is important that each family understand how their information may be presented and
document their consent choice on the consent form. SDW should give a brief explanation
regarding on the content of the consent form. All new sponsored families joining the program
must have this consent documented, applicants must be affixed their signature in the consent
form as one of the requirements on the recruitment process

If a family gives consent, we will be able to include their photograph or story in Unbound
materials in print and online for communication and promotional purposes concerning the
program. For those available for sponsorship, the consent of a family will allow us to make their
photograph (a head and shoulders image of the sponsored member) and brief description
available on the Internet for new sponsors to choose from. We call these short descriptions
‘online profiles’:

The online profiles are not intended to serve as an online relationship-building mechanism.
Unbound prohibits direct communication between sponsor and sponsored. Also, when a family
gives us their consent, it is not a guarantee that they will be featured on the Unbound website.
Only a selection of available children, youth, or elders will be available online at a given time.
Unbound will also use traditional sponsorship acquisition efforts, such as church appeals, for
those who give consent. 

The online profiles exclude last names and the village or community where the individual lives.
The profiles seek to express the humanity within the family and avoid saying anything that
might make a youth or family feel exploited. Unbound-Kansas will attempt to exclude anything
that could cause harm to the child’s, youth’s or their family’s dignity. 
Each family is free to decline consent for inclusion in publications, promotional materials, or
online acquisition efforts. This does not impact the status of the family in the Unbound
sponsorship program. When a family declines consent, Unbound will not post the profile online
but will continue to use their photo and family profile in traditional sponsor invitation efforts.  

Each family awaiting sponsorship must be given the opportunity to provide or decline their
consent, and this choice should be documented on the family record in Portal and on a consent
form (see Appendix) to be kept at the project. If a family chooses to give consent, they should
sign the consent form. If a family chooses to decline consent, they are not required to sign the
consent form. However, in either case, the Unbound staff member needs to sign the consent
form and note the family’s choice on the family record in Portal.

Consent Form Sample

Consent for Communications

Unbound and _______________________ (project name) would like to share stories of sponsored
members and their families in order to educate and inform current and potential sponsors, and
the general public.

By signing this consent, you agree to allow Unbound to share your family’s story and describe
your participation in the sponsorship program through information, stories, photographs, video
and audio recordings, in printed publications, promotional materials, on the Internet and
through any media format published by Unbound or authorized for use by Unbound.

The Internet option will include posting profiles of children, youth and elders waiting to be
sponsored. However, this is not intended to serve as an online relationship building mechanism.
No direct communications via the Internet will be allowed between sponsor and sponsored.

Unbound will only present information about your family in a dignified way that will respect
your privacy. Your decision whether or not to participate will not affect your sponsorship in any
way.

Sponsored Member’s Name (Print): ____________________________________

Signature: ____________________________________
Parent/Guardian (If child under 18 years): ____________________________________
Date: ____________________________________

I verify that the above signed has been informed properly before signing this consent.
Name of Unbound Staff (Print): ____________________________________
Signature: ____________________________________
Date: ____________________________________
For Unbound use only

Consent Form Tagalog Sample

Pahintulot sa Patalastas

Ang Unbound at _______________________ (project at subproject) ay nagnanais na magbahagi ng

mga kwento ng mga sponsored members at kanilang mga pamilya na naglalayong maturuan at
maipaalam sa mga kasalukuyan at potensyal na sponsors, at ang pangkalahatang publiko.

Sa pamamagitan ng paglagda sa pahintulot na ito, ikaw ay sumasang-ayon na payagan ang

Unbound at _______________________ (project at subproject) na ibahagi ang kwento ng inyong
pamilya at ilarawan ang inyong pakikilahok sa sponsorship program sa pamamagitan ng mga
impormasyon, kwento, larawan, video at audio-recordings, nakalimbag na lathalain,
pampromosyong materyal, sa Internet at sa anumang format ng media na nailathala sa
pamamagitan ng Unbound o pahintulutan para magamit ng Unbound.

Kabilang sa pagpipilian sa Internet ay ang paglalagay ng mga profile ng mga bata, kabataan at
matatanda na naghihintay magkaroon ng sponsor. Gayunpaman, hindi ito inilaan upang
magbigay daan sa pagbuo ng online na ugnayan sa kanilang pagitan. Walang anumang
komunikasyon sa pamamagitan ng Internet ang papayagang mamagitan sa isang sponsor at sa
kanyang sponsored.

Ang Unbound ay magpapakita lamang ng mga impormasyon ukol sa inyong pamilya sa isang
marangal na pamamaraan na magbibigay galang sa pagiging pribado ng sinuman. Ang inyong
pagpapasya ng pakikilahok o hindi pakikilahok ay hindi makakaapekto sa iyong sponsorship sa
anumang paraan.

Pangalan ng Sponsored Member (Print): ____________________________________

Lagda: ____________________________________
Magulang/Guardian (kung ang bata ay 18 pababa): ____________________________________
Petsa: ____________________________________

Pinatototohanan ko na ang nakalagda ay lubusang nauunawaan ang nilalaman bago markahan

ang pahintulot na ito.
Pangalan ng Unbound Staff (Print): ____________________________________
Lagda: ____________________________________
Petsa: ____________________________________

1.1.5 Interview Guide Questions for Child and Youth

BASIC INFORMATION
Record ID:
CHID:
Type:
Child Status:
Record Status:
Project-Zone-Sub:
Area:
Community Group:
Staff Responsible:
SL/UR Reference Number (if applicable):

First Name:
Middle Name:
Last Name:
Likes to be Called (Nickname):
*If the person is always called by his/her first name, the “Likes to be Called” field should be left
blank.

Gender:
Date of Birth: Estimated? YES_____ NO _____
Age:

Consent: YES_____ NO _____

*By selecting YES, you agree to allow Unbound to share your family’s story, photos, and other
information through printed publications, promotional materials, on the internet, and through
any media format published by Unbound or authorized for use by Unbound.

A. BACKGROUND

Address:
Village/ Town/ Neighborhood:
Language Spoken:
Religion:

Jobs at Home:

 How does the child helps the family with the housework’s?
 What are the household chores he/ she can and usually do?
 What are the household chores he/she tries to learn or do?
 How often does he/she do these chores at home (occasionally/sometimes/daily)?

Health Status

GOOD _______ FAIR _______ POOR _________

*If an individual is in “GOOD” health, additional commentary is not required (such as "She is in
good health" or "He does not have any illnesses"). If an individual catches an occasional illness
like the common cold, but otherwise has no chronic or current health issues, we consider them
to be in good health.
*If a person has “FAIR” or “POOR” health, please provide detailed information about their
specific condition(s).
*If an individual is in “FAIR” health, he/ she may be sick or feeling ill but has no definite kind of
illness that requires maintenance medicine or serious kinds of treatments.

Health Comments

 How good is the child’s health? Is it rounded, moderate or skinny?

 What is the child’s height and weight? Is it appropriate for his/her age?
 Is the child on the list of the feeding program in school? If so, when do they get fed?
 What are the usual meals that the teachers or parents prepare for the kids?
 Have you attended a health lecture concerning the right feeding technique for the child?
If so, Who facilitates it? Is it done in the school or at the health center?
 How is child’s skin, eyes, teeth? How does he/she keeps body clean and healthy?
 What is the child’s favorite food specifically vegetables and fruits?
 Does the child like rice for breakfast?
 What local foods does the child likes? Does child likes dry foods such as fried fish, fried
chicken? Or child likes vegetables soup such as pork sinigang and nilaga?
 (Give name of dishes that the child likes.)
 What are the child’s favorite snacks in the afternoon after taking a nap?
 During recess time, what does the child eats?
 Does the child pack his/her own snacks or the parents bring the snacks? (To ensure what
child eats is clean and healthy).
 If you give your child his/her allowance what do you ask him/ her to buy and eat?
 What time does the child usually sleeps at night and what time he/she wakes up?
 In the morning, is the child energetic, quickly moves to bathe, have his/her meal, and
prepare her/himself for school?
 For the child’s immune system and appetite, do you give your child milk and vitamins
every day? What milk and vitamins does the child takes to ensure it contributes to
his/her better health? Were you able to maintain his milk and vitamins every month?
 What good effects have you notice on your child’s health?
 How many times in a month or a year do you take your child to the health center for
regular check-up and monitoring of the health?
 If you don’t, then, how do you monitor your child’s health when you are at home and
even when the child is not sick?
 When your child has fever, cough, cold or other kind of illness and you have no money
to buy medicines, what action/s do you do to help your child recover and get well?
 Do you know home remedies that you can use to will help your child get better?
 If in case for example, your child has asthma or any other usual illness what are some of
the ways in which you and your spouse do, to whom do you go for help? Can you ask for
help from relatives and the local barangay official?
 What are his/her illness? How serious it is? How does it affect your body and health?
 How and when did you get this kind of illness?
  What kinds of medicines do you take? How long is the treatment? Do you take
maintenance medicines?
 How often do you visit the doctor for check-up?
 Have you undergone an operation/ surgery or medical procedure in the past?
 What are some of the things you cannot do due to illness or being?
 What kinds of activities/ therapies you are taking to recover health based on the doctor’s
recommendations?
 What kinds of food do you need to recover? And what should be avoided?

What is your favorite thing to do (Activities, Talents, Pastimes)?

 What is your hobby at home?

 Example: cut a paper doll and dress for young girls and kite making and flying for the
young boys
 When you are outside your house and playing with a friend, what does you and your
friends like to play? (patintero, hide and seek, luksong tinik, langit lupa etc?
 Do you also play inside your house or your friend’s house sometimes?
 What is your interest and what is your talent? Or you want to learn, like for example,
bicycling or playing guitar?
 What are the things/activities you enjoyed the most? Who joins you on those things/
activities?
 What do you do on your free time? Who accompanies you?
 Are you affiliated/ associated to any groups? (Church, community, sports, other than
school organizations)
 Have you joined to contests/ competitions before (aside from school competitions)?
What are the awards/ recognitions you have received?

Additional Information (personality etc.)

 What are the child’s good qualities and characteristics?

 What makes them stand out from the others?
 How the child socializes with her siblings, as well as with playmates and school mates?
 When you correct your child’s bad behavior or actions, how does child respond? Does
child listen and say sorry/ apologized?
 At a young age of your child, do she/ he already have a desire to be when she grows up?
What is it and why?
 What was the child’s favorite subject and why? And what are other subject or interest in
school that child wants to learn?
 What is the child’s favorite color? Song or game? Can your child entertain him/ herself
even alone or cannot?
 What is the child’s favorite meal? Fruits? Color? etc
 What skills are they currently developing?
 How do they interact with others?
 Are they outgoing or reserved?
 Are they laid-back or energetic?
 What makes them smile?
 What calms them when they are upset?
  What games do they enjoy playing?
 What do they like to do when spending time with friends or family?
 Is he/she the eldest child in the family? Only child? Only male/female child in the family?
 What adjectives would they use to describe themselves?
 How do they enjoy spending free time?
 What is their favorite thing about themselves?
 What are their dreams for the future?

B. FAMILY

Mother
First Name:
Middle Name:
Last Name:
Occupation:
Does the child/youth live with her or under her supervision?
Is the mother present?
If not present, why?

Father
First Name:
Middle Name:
Last Name:
Occupation:
Does the child/youth live with him or under his supervision?
Is the father present?
If not present, why?

Guardian
First Name:
Middle Name:
Last Name:
Occupation:
Does the child/youth live with her/him or under her/his supervision?

Guardian’s Relationship to child/youth:

*List all of the parent’s occupation (whether it is a regular job or not.) Separate each of the listed
jobs by using a comma (,).
*If both parents or one of the parents doesn’t have a job, use “Housewife” for the mother’s
occupation or “Househusband” for the father’s occupation. Do not use the word “None” or
“Unemployed”. If the parent’s work is driver, add what type of vehicle he/she is driving. Example:
Taxi Driver, Bus Driver, Tricycle Driver, etc.
Number of Brothers:

Number of Sisters:

*Include the exact count of brothers and sisters in the family including stepsiblings and those
who are no longer staying in the family’s home.

What makes this family unique?

 What are the processes that you and your family do to keep your home and relationship
smooth and united?
 How do you treat your children and how are you to each other, as parents? What are the
good things that you do as a parent that your children look up too as a good example?
In times of financial or any problem, how do to cope, act, fix the problem? Does
everyone get involved in finding a solution? Does the elder children have say in the
house and their suggestion is consider?
 What community and church activities or other organization are you participating in?
How do you help and in the same way, how your family was helped too? Are you also
getting involved your children in the activities? For example? Couple for Christ and
others
 Despite of the financial shortcomings, do you and your family still get a chance to
celebrate your birthday, holiday, family reunion and others? How do you do this, in what
way? When your family member remembers important day in your life, how do you feel?
Or how do they feel? How do you express your love and gratitude?
 When you are at home all weekends, in what way are you spending time together? Do
you work together? How everyone gets involved?
 As a parent we know that you are busy with work and most of the time when you reach
home was tired. Are you still able to teach your children in their lesson? If not, is there
anyone else in the family who teaches the younger children like their older siblings?
 Is the family complete?
 Are parents separated? Single? Widowed? Or living with his/her new partner?
 If both parents or one parent died, when did he/she passed on? Who takes care of the
children?
 Do they observe any religious, cultural, or familial traditions?
 What are their religious beliefs? Prayer Time? How often or when do they go to church
or attend mass? Do they attend bible service? Are there any church activities they enjoy
the most?
 Favorite sports and hobbies of the family which they consider as their bonding activity?
(Picnic, watching movies, videoke singing, sewing, chatting with one another, etc.)
 What positive character traits or behaviors are displayed and/or encouraged in the
home?
 What expectations have the parents set for their children?
 How does the family divide household labor?
 How do they manage conflict when it arises?
 Are they close with extended family, such as grandparents or cousins?
 What type of family are they considered? (Nuclear, Extended, Blended)
 Do the parents help the children with their homework?
 Do older siblings or other family assist with childcare?
 How do the family members relate to each other?
  Do they communicate openly?
 What is their typical routine?
 Do they share leisure time?
 Are there any awards/recognitions received by the family or any of the family member?

Child/ Youth’s Unbound goal

 Why would you want your child to join in the foundation? How do you think the child
will be benefited from the sponsorship program?
 What can you promise and do to show to your sponsor that he / she had the right
decision of choosing and helping you?
 What do you want to achieve in life that Unbound can help you accomplish?
 What do you want to do in the future?
 What kind of person do you want to be?
 What do you think you can accomplish with Unbound’s help?
 (If the child is younger, these questions can be directed to the mother, father or
guardian): What do you hope your child will be able to achieve with Unbound support?
 How do you hope your child’s life will be different in the future? Can Unbound help?
 What other things you would like to learn from the program
 What skills/potentials/talents you would like to acquire/ develop with the help of
Unbound and what steps will you need to take?
 Why do you want to finish your schooling?
 What is your dream career/ profession?
 What kind of learning/values you would like to shares with the others and to your
community?
 Who do you want to thank for achieving your dreams?
 What places you would to travel or visit now or in the future?
 What is your dream for your family?
 How would you help your family?

*For the child who cannot speak for him/herself due to very young age, parent/s or guardian
can answer.

Family’s Unbound Goal

 Why would you want your child to join in the foundation? How do you think the child
will be benefited from the sponsorship program?
 As you often say, you want your child to finish school, with the help of the foundation,
but we are telling you that the help is not enough to help the education and other needs
of your child, and beside you have other children, what will you do to provide for the
entire needs of your children?
 In the reality of your life situation, what do you really want to have to achieve your
goals?
 What is the ultimate dream of your family, that in the future and with the help of the
foundation, with your hard work, you want to achieve for you and your family? What are
the things that you don’t have now and want to have in the future?
  How would you like your life to change/improve with Unbound’s help?
 As a family, what is your dream or hope for the future? (It can be relating to education,
business, home, land purchase, health, etc.) How do you think Unbound can help?
 In what ways will you be able to maintain good health and nutrition of the family?
 What steps will you take to achieve your dreams?
 What else you would like to learn from the sponsorship program? Are there any talents
or skills you would like to develop? What are those?

C. LIVING CONDITIONS

*In what type of material do the following parts of your house made of:
Walls:
Floor:
Roof:

Cooking:
a. Gas
b. A Stove
c. Charcoal
d. Wood
e. Others ___________
*”Gas” as listed in the “Cooking” selection refers to LGP Tanks.
*“A stove” refers to electrical stove.

Electricity: YES _____ NO _______

*Select “YES” even you don’t have own electric line connection or just sharing with a
neighboring house.

Water Supply: ____________________________________

*Provide the source of where the water supply comes from. Example: “The family is fetching
water from their own faucet.”; “The family is fetching water from a deep well.”; The family buys
drinking water.”

Sleeping Set Up:

a. Metal bed
b. Bamboo bed
c. Wooden bed
d. On floor
e. Others _________
Mattress (Foam): YES _____ NO _____

Mat: YES _____ NO _____

Blanket: YES _____ NO _____

Shared: YES _____ NO _____

*Select “Yes” if you are sharing the same bed with any of the family member.

Number of People living at home:

*How many people are living in the house?

Approximate monthly household income (in dollars):

*How much is the combined earnings of the family? (Estimated)

Describe source(s) of income

 What is the main source of income of the family? Are there any extra/sideline jobs of the
family?
 If you are a farmer, how long have you been farming?
 For example: If the father is farmer, what kind of vegetable is planted? Is there specific
vegetable that he planted every month? Does he buy the seedlings? How long the crops
be ready for harvest? Does the father have a wholesales buyer, or he just sells it at the
public market or in the village/ barrio only? Is the father gain and lose?
 When there is no income in driving a tricycle or in the construction, what is the father’s
other means does to earn money?
 Does the father know other job that is available in the area?
 Apart from the mother’s job at home, doing housework’s and others, does mother help
financially? How does she earn? How often the mother earns? Where she usually uses
the money?
 Is there an elder child that is working already? How many? What is their age? What is
their job? Is their job regular or temporary? Are the children able to provide assistance
for daily foods and other needs at home, how often they share? Every week or monthly?
 Do you or your husband have siblings or parents that help you financially? Or if they
can’t help financially in what way they were able to help you?
 Does the family run a business/ livelihood? What is it?
 Are the jobs of the parents regular, casual, part time? How many days in a week do they
go to work? When do they receive their earnings? What are the specific tasks they need
to accomplish at work? For example: factory worker, is he/she assigned to sew clothes,
cut textiles, etc.
 Is there someone in the family who works abroad? What is her/his jobs? How long is
their job contract? Do they regularly send financial support?
 If they borrow money from someone, how do they pay for their debts?
Additional information about the living conditions and/ or community.

 Is the land and the house your own? Inherited? Renting? Or do you live in the house of
the grand parents or relatives? How long have you been living here? How many families
live here? Have you before when you start a family live in your house even though it was
shack made?
 How do you feel if you had another family living in same roof with you? Is it easy?
Especially if the family is your spouse parents or siblings? Are you feeling comfortable?
 If you are renting a house, how much do you pay every month? Is the water and electric
bill included or not? Were you able to pay every month? How many times now that you
moved from house to house and why it has to happen? What it feels like to live be in
this situation?
 If you are living with another family at home, how are you doing with cooking? How do
you sleep? How do you divide water and electricity bills payment?
 How many bedrooms do you have? Does you and your spouse have your own and your
children have theirs too?
 Is there enough space in your house, with a kitchen, living room, bedroom and comfort
room? Do the doors and window have strong locks? Is the foundation of the house
strong or weak? Which part of the house do you think that needs repair for the safely
and comfort of the family?
 Can the fresh air get inside the house freely? Is it ventilated and cozy? Or is it narrow and
dark inside? What is your feeling with this?
 For the duration of your stay in the area, how was your neighbor? How do you get along
with them and they to you and your family? Is your children safe; is it far from the
highway and vehicles?
 What your surroundings look like? What do you see around your house, aside from the
houses of other people?
 Do they live with extended family? If so, does the family have a separate living space?
Are expenses like food and utilities shared?
 Are the furnishings adequate?
 Is the home structurally sound?
 Are there issues due to poor insulation or ventilation?
 Do they have access to a latrine?
 What is the quality of the infrastructure, such as roads, utility services, etc.?
 How many schools are in the area, and how many grade levels can be completed
without traveling to another community for school?
 How do they travel into or out of the community?
 How do the neighbors typically interact with each other?
 Does the community have communal spaces like parks?
 Are there any festivals or traditions observed in the area?
 Does the family feel safe in their community?
 Are there many employment opportunities available?
 What types of work are most common in this area?
 What is the typical climate? Does it affect the family's daily life or economic
opportunities?
 Is the family from the area? If not, what brought them to their current community?
  Is it accessible to hospitals, public markets, town proper, health care center, school,
church, municipal office, government facilities, business establishments, parks? How far
is your home from these establishments?
 Is your home close to the main road?
 Describe the community. Is it a government housing project, far from the service road,
away from most of the houses? Is it prone to flood? Is it close to the
river/creek/seashore/rice fields?
 Are public vehicles/ transportation services accessible?
 If there is no own electricity and water line connection, what do you use to have light?
Where do you get water?
 Does the roof of your home leaks?

SPECIAL NEEDS
*If an individual has special needs, please take care to describe the challenges they face due to
their illness. While it is valuable to share the specific diagnosis, many conditions manifest with
different symptoms and levels of severity depending on the individual. For this reason, listing a
diagnosis alone is not sufficient when submitting a record for an individual with special needs.

Does this person have any physical or mental limitations that will prevent him/ her from
fully caring for him/herself long term? YES _______ NO _________

*Below are examples under this category.

-Work related injuries-especially to the upper extremity

-Amputees and people with special prosthetics
-Stroke or heart attack victims
-People with arthritis, multiple sclerosis or permanent disabilities
-People with mental health problems
-People with head injuries
-People suffering from severe burns and spinal cord trauma
-Fabricate custom orthotic devices to increase functional ability or prevent a deformity of the
upper extremities
-Mentally ill or emotionally disturbed individuals by teaching them coping skills

Describe specific limitations or challenges.

 What is your illness? Physical? Mental?

 What are the things you are capable of despite having this condition?
 For the things/activities you cannot do/make, what kind of assistance/help do you need
in order to do it?
 How do you communicate with your family?

Have you considered an educational plan or occupational therapy that will help him/ her
to become more self-sufficient? If so, describe the plan.
  Have you visited the doctor for check-up? How often or when do you need to have your
check up?
 What are the recommendations of the doctor? Medications/ therapy, etc.?
 What kinds of food are you allowed to eat? What should be avoided?

How will this person and family benefit from the sponsorship program?

 How can Unbound help you on your needs?

 In what ways does Unbound can help improve your condition/ situation?
 How does your participation in the program affect you as a member/individual?

D. EDUCATION

*If the individual is not attending school, he/she is still required to provide information in all
fields, and the details why he/she is out of school.

Attends School? YES_____ NO _____

If not attending school, why?

Current grade in school:

What is the member’s current grade/year level?

Favorite Subject(s):

Name of School:
Is it public or private?

Approximate Distance of current school from home:

How far is your home from school?
How many minutes/hours of travel does it take for you to reach school?

Mode of Transportation to school:

Do you walk to school or take a tricycle/jeepney/bus/etc.?

Additional Education information

 How is your child’s doing in school, does your child have fun? Learn? Is your child
diligent?
 What is the child’s favorite subject and activities (such as; writing, drawing, translating
tagalong name of animal or things in English)
 How your child interacts with classmates, does child also play and join in group
discussion?
  Is your child excited for school, and when he/ she got home from school is telling you
nice things about school, teacher, classmates and what child has learned. When child get
a star or good grade, is very proud to tell you and everyone in the family? Does child
anticipate the next school days?
 Has your child received an award, and belong to the honor pupil and has joined different
quiz bee or other school contests? What child wanted to join to in school in the coming
school season?
 What else does your child engaged with in school as his/ her extracurricular activities,
such as lyre band, sports, girl/ boy scout, dancing, singing and more
 What are some of the school activities you enjoy doing?
 Is there a guard at the gate that monitors the coming in and out of the student and
teacher? Is there a canteen where the children can buy healthy foods? Is the canteen
staff cook the food in the canteen or it was delivered by the different vendor, and is safe
for the children?
 How does the child behave in school? (quiet, physically active, shy, expressive, etc.)
 In what aspect of learning does he/she excel? (drawing, writing, reading, speaking,
reciting, examinations, sports, extra-curricular activities, academics, etc.)
 How active is the child in class? Does he/she often leads the group, actively participates
in class recitation, trusted and compliant to his/her teacher, often joins to competition?
 Is he/she friendly in school? Does he/she plays during breaktime/recess?
 Is he/she a member of any school organization/clubs?
 How do you describe your school? Does it have a complete facility? How’s your teacher’s
way of teaching?
 What is your modality of learning?
 If you are one of the officers in your class, what position where you assigned.
 Did you take an off from school? If yes, why did you took an off, when/how long?
 If you are currently not attending school, when do you plan to resume classes? What is
your plan while waiting for opening of classes?

Career/Educational Goal

 What course of study do you plan to take in college?

 What is your dream career? Profession?
 What steps do you need to take to achieve that?

Estimate Graduation Month

 When will you graduate in senior high school? Provide month and year.
 When will you graduate in college? Provide month and year.
1.1.6 Interview Guide Questions for Elder

A. BASIC INFORMATION

Record ID:
CHID:
Type:
Child Status:
Record Status:

Project-Zone-Sub:
Area:
Community Group:
Staff Responsible:
SL/UR Reference Number (if applicable):

First Name:
Middle Name:
Last Name:
Likes to be Called (Nickname):
*If the person is always called by his/her first name, the “Likes to be Called” field should be left
blank.

Gender:
Date of Birth: Estimated? YES_____ NO _____
Age:

Consent: YES_____ NO _____

*By selecting YES, you agree to allow Unbound to share your family’s story, photos, and other
information through printed publications, promotional materials, on the internet, and through
any media format published by Unbound or authorized for use by Unbound.

B. BACKGROUND

Address:
Village/ Town/ Neighborhood:
Language Spoken:
Religion:

What would you like to share about yourself?

 Are you married/ widowed/ separated/ single?

 How many children did you have? Give names, ages, grade level of your children from
the elder to the youngest. If you have children in your previous marriage, you can add
too and give details if they are living with you or not.
 How many grandchildren did you have? Do they have families of their own already? Do
they live with you?
 What are you and your spouse educational attainment? Why did you stop? How many
children are you in the family and what was the source of income of your parents then?
 What are your ages now? And what was your age when you start a family?
 What was you and your spouse job before you met? Where you met?
 Who keep and record the budget for the daily expenses of the family? Who is the one
that buys commodities?
 In their housework’s, are there a division of work for the family member? Such as who
will do the dishes during breakfast, lunch and evening? And other chores. Is the father
sometimes helps or lead family cooking at home?
 What are some of your usual tasks at home?
 How was your life during your younger years? Were you able to attend school? What
was your highest educational attainment?
 Who accompanied you in your growing years?
 Are you a native of your community or you lived in a different province?
 What age did you started to work?
 What are some of your most unforgettable experiences? Happiest experience in life?
 What are your dreams in life? Were you able to achieve some of those?
 What are some awards/ recognitions you received over the past years?

Health Status

GOOD _______ FAIR _______ POOR _________

*If an individual is in “GOOD” health, additional commentary is not required (such as "She is in
good health" or "He does not have any illnesses"). If an individual catches an occasional illness
like the common cold, but otherwise has no chronic or current health issues, we consider them
to be in good health.
*If a person has “FAIR” or “POOR” health, please provide detailed information about their
specific condition(s).

*If an individual is in “FAIR” health, he/ she may be sick or feeling ill but has no definite kind of
illness that requires maintenance medicine or serious kinds of treatments.

Health Comments

 What are his/her illness? How serious it is? How does it affect your body and health?
 How and when did you get this kind of illness?
 What kinds of medicines do you take? How long is the treatment? Do you take
maintenance medicines?
 How often do you visit the doctor for check-up?
 Have you undergone an operation/ surgery or medical procedure in the past?
 What are some of the things you cannot do due to illness or being?
 What kinds of activities/ therapies you are taking to recover health based on the doctor’s
recommendations?
 What kinds of food do you need to recover? And what should be avoided?

What is your favorite thing to do (Activities, Talents, Pastimes)?

 What are your talents and hobbies?

 What do you do on your free time?
 What kind of television shows do you usually watch or likes the most?
 Do you often listen to radio? What types of music do you listen to? What kinds of radio
program you enjoy the most?
 Do you take a nap in the afternoon? Do you wake up early or sleeps late?
 What are the things you enjoy doing with your friends?
 What community/ church/ group activities do you often participate with?

Additional information (personality etc.)

 What makes you proud? What makes you happy?

 What challenges have they faced and/or overcome?
 If so, what do they enjoy doing together?
 What is your favorite meal to prepare or eat?
 What are some of your characteristics/behavior/attitude?
 What are your hopes and beliefs? What leaning/values you would like to share with
others?
 What are your favorites? Food? Color? Fruits? Music?

C. LIVING CONDITIONS

*In what type of material do the following parts of your house made of:
Walls:
Floor:
Roof:

Cooking
f. Gas
g. A Stove
h. Charcoal
i. Wood
j. Others ___________
*”Gas” as listed in the “Cooking” selection refers to LGP Tanks.
*“A stove” refers to electrical stove.

Electricity YES _____ NO _______

*Select “YES” even you don’t have own electric line connection or just sharing with a
neighboring house.

Water Supply ____________________________________

*Provide the source of where the water supply comes from. Example: “The family is fetching
water from their own faucet.”; “The family is fetching water from a deep well.”; The family buys
drinking water.”

Sleeping Set Up

f. Metal bed
g. Bamboo bed
h. Wooden bed
i. On floor
j. Others _________

Mattress (Foam) YES _____ NO _____

Mat YES _____ NO _____

Blanket YES _____ NO _____

Shared YES _____ NO _____

*Select “Yes” if you are sharing the same bed with any of the family member.

Number of People living at home:

*How many people are living in the house?

Approximate monthly household income (in dollars):

*How much is the combined earnings of the family? (Estimated)

Describe source(s) of income

 What is the main source of income of the family? Are there any extra/sideline jobs of the
family?
 Is there an elder child that is working already? How many? What is their age? What is
their job? Is their job regular or temporary? Are the children able to provide assistance
for daily foods and other needs at home, how often they share? Every week or monthly?
 Do you or your husband have siblings or parents that help you financially? Or if they
can’t help financially in what way they were able to help you?
 Does the family run a business/ livelihood? What is it?
 Are the jobs of the parents regular, casual, part time? How many days in a week do they
go to work? When do they receive their earnings? What are the specific tasks they need
to accomplish at work? For example: factory worker, is he/she assigned to sew clothes,
cut textiles, etc.
 Is there someone in the family who works abroad? What is her/his jobs? How long is
their job contract? Do they regularly send financial support?
 If they borrow money from someone, how do they pay for their debts?

Describe the elder’s past and current means of making a living

 How do you earn in the past? What is your job before?

 How do you earn at present? What is your current job?

Additional information about the living conditions and/ or community

 Are the furnishings adequate?

 Are there issues due to poor insulation or ventilation?
 What is the quality of the infrastructure, such as roads, utility services, etc.?
 How many schools are in the area, and how many grade levels can be completed
without traveling to another community for school?
 How do they travel into or out of the community?
 Is public transportation accessible?
 How do the neighbors typically interact with each other?
 Does the community have communal spaces like parks?
 Are there any festivals or traditions observed in the area?
 Are there many employment opportunities available?
 Does it affect the family's daily life or economic opportunities?
 Is the family from the area? If not, what brought them to their current community?
 Is it accessible to hospitals, public markets, town proper, health care center, school,
church, municipal office, government facilities, business establishments, parks? How far
is your home from these establishments?
 Is your home close to the main road?
 Describe the community. Is it a government housing project, far from the service road,
away from most of the houses? Is it prone to flood? Is it close to the
river/creek/seashore/rice fields?
  Are public vehicles/ transportation services accessible?
 If there is no own electricity and water line connection, what do you use to have light?
Where do you get water?
 Does the roof of your home leaks?
 What are the common jobs available in the area?
 If you are renting a house, how much do you pay every month? Is the water and electric
bill included or not? Were you able to pay every month? How many times now that you
moved from house to house and why it has to happen? What it feels like to live be in
this situation?
 If you are living with another family at home, how are you doing with cooking? How do
you sleep? How do you divide water and electricity bills payment?

SPECIAL NEEDS

*If an individual has special needs, please take care to describe the challenges they face due to
their illness. While it is valuable to share the specific diagnosis, many conditions manifest with
different symptoms and levels of severity depending on the individual. For this reason, listing a
diagnosis alone is not sufficient when submitting a record for an individual with special needs.

Does this person have any physical or mental limitations that will prevent him/ her from
fully caring for him/herself long term? YES _______ NO _________

*Below are examples under this category.

-Work related injuries-especially to the upper extremity

-Amputees and people with special prosthetics
-Stroke or heart attack victims
-People with arthritis, multiple sclerosis or permanent disabilities
-People with mental health problems
-People with head injuries
-People suffering from severe burns and spinal cord trauma
-Fabricate custom orthotic devices to increase functional ability or prevent a deformity of the
upper extremities
-Mentally ill or emotionally disturbed individuals by teaching them coping skills

Describe specific limitations or challenges.

 What is your illness? Physical? Mental?

 What are the things you are capable of despite having this condition?
 For the things/activities you cannot do/make, what kind of assistance/help do you need
in order to do it?
 How do you communicate with your family?
Have you considered an educational plan or occupational therapy that will help him/ her
to become more self-sufficient? If so, describe the plan.

 Have you visited the doctor for check-up? How often or when do you need to have your
check up?
 What are the recommendations of the doctor? Medications/ therapy, etc.?
 What kinds of food are you allowed to eat? What should be avoided?

How will this person and family benefit from the sponsorship program?

 How can Unbound help you on your needs?

 In what ways does Unbound can help improve your condition/ situation?
 How does your participation in the program affect you as a member/individual?