Request edit access
Application form to PROVIDE humanitarian help
Please fill in this online application form to provide humanitarian help.

CO "Heraskevych Charity Fund" respects your personal data confidentiality and will do its best to provide for the highest level of security for your personal data handling.

Sign in to Google to save your progress. Learn more
Email *
1. Contact information
Please state your contact information for feedback.
First name, Family name: *
Phone humber: *
Who is offering humanitarian help? *
If you replied "A legal entity" above, please state the name of the company:
Please choose the type of help you would like to provide : *
2. Description of humanitarian help  
If you would like to help by providing humanitarian help (food, products, technical means, etc.), please fill in this part:
Please choose the category of help with which you would like to help:
Approximate volume of humanitarian help:
I'm offering humanitarian help from (in the field below please specify the country, the city, or other necessary details):
Clear selection
Any additional information regarding humanitarian help you can provide:
3. Please describe here volunteer activities in Ukraine you could offer:
If you would like to become a Fund's volunteer, please fill in the category below
Sphere with which you would like to help:
Please state any additional information about the help you would like to provide:
Thank you!
We very much appreciate your help to Ukraine and its citizens, it is very important and priceless!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy