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Proposal for HUMANITARIAN AID supply to the Centre of Humanitarian and Medical Aid "Help Ukraine"
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Name and Surname:
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Contact number (mobile):
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Email address:
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Date of departure:
MM
/
DD
/
YYYY
Expected arrival date:
MM
/
DD
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YYYY
Expected arrival time:
Time
:
AM
PM
Country of departure:
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City of departure:
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Type of vehicles:
Van
Truck
Car
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Expected number of vehicles:
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Truck plate number(s):
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Name and surname of the driver(s):
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Mobile number of the driver(s):
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App. amount of humanitarian aid (in pallets, cubic m, or tonnes):
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Type of package:
Boxes
Pallets
Bags
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Other:
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Type of humanitarian aid:
First aid
Medicine
Personal belongings
Personal hygiene
Food
Housewares
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Other:
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Type of humanitarian help:
Addressed help to specific organisation
General help to Ukraine
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Comments:
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