Get help

Get help

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Type of help *:

Name *:

Email *:

Password*:

Confirm password:

Tel./ mob. *:

Information about the project

Project name *:

Name(who needs help) *:

Date of birth *:

Дiagnosis*:

Region *:

City оf residence *:

Project description *:

Required amount *:

Where will the treatment be? *:

Attach documents of pictures

Pictures of the project *:

Application by parents *:

Passport(1st and 2nd page) *:

Birth certificate *:

Additional information :

Treatment indications *:

Bank account of the hospital *:

 

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   I promise to post an information about the Fund on other websites.

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