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.
1. Contact information
Please state your contact information for feedback.
First name, Family name:
Who is offering humanitarian help?
A private individual
A legal entity
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 :
Humanitarian help (goods)
Volunteer help (physical help of volunteers) in Ukraine
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:
Clothes / blankets / bed linen, etc.
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):
an EU country
another Ukrainian city
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:
We very much appreciate your help to Ukraine and its citizens, it is very important and priceless!
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service