The E5 Foundation supports community initiatives focused on healthcare access and education. If you or your community require assistance related to healthcare support or educational development through Inkwell Academy, please submit your request below. Our team will review submissions and respond where support programmes are available.

Please enable JavaScript in your browser to complete this form.

Support the "Other"

Full Name *

First

Last

Email Address *

Mobile or WhatsApp Number

Province *— Select Choice —Eastern CapeFree StateGautengKwa-Zulu NatalLimpopoMpumalangaNorthern CapeNorth WestWestern Cape

City/ Area

e.g. Soweto, Polokwane, Kimberley

Type of Support Needed *— Select Choice —Healthcare SupportCommunity Healthcare ProgrammePatient Care SupportDisability SupportEducation Support (Inkwell Academy)Learner Support (Maths / Science / English)School or Community Education ProgrammeOther

If "Other" Describe the Request

Please briefly describe the support required.

Organisation Name (optional)

If request is for a school or community group.

Additional Information

Please briefly describe additional information.

Support Category *— Select Choice —Healthcare Access SupportPatient Care CoordinationDisability and Special Needs SupportCommunity Health Programme SupportMedical Outreach / Community Clinic SupportEducation Support (Inkwell Academy)Learner Support – MathematicsLearner Support – ScienceLearner Support – ScienceSchool or Community Education ProgrammeEducational Resources or Learning SupportOther

Describe the Support Request

Please briefly describe the assistance required, who the support is for, and the location of the request.

Who is the request for?IndividualFamilySchoolCommunity OrganisationNon-Profit OrganisationCommunity GroupOther

Submit