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Swan Application
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Swan Application
Swan Application
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Your Name
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Date of Birth
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Gender
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Male
Female
Address Line 1
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Address Line 2
Country
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State/Province/Region
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City
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Postal / Zip Code
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Phone Number with dialing code
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Email
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Marital Status
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Number of Dependants
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2
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4
5
6
7
9
Educational Qualification
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Training, if any
Skills
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Occupation
If unemployed, provide reason for unemployment
Employment history with dates and description of employment
From Date
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To Date
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Two employment references
Name
Email
Phone Number
Name
Email
Phone Number
Documents Upload
Upload Educational Certificates
Upload Educational Certificates
Upload Educational Certificates
Number of family members
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1
2
3
4
5
6
7
9
Please specify
Document Upload (Upload ration card or other proof of family)
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Document Upload (Upload educational certificates of family members)
Monthly income of person in need
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Assets of person in need
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Source of income
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Documents Upload
Upload bank statement of past 3 months
Upload pay slips for last 3 months
Upload proof of other income
Upload proof of assets (If you don't own any assets, attach self-attested affidavit)
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Monthly Income of family
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Name of the income earner and relation with person in need
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Assets of family
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Choose one of the options below to describe the help needed
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Legal Representation for Civil and Human Rights Advocacy
Education
Employment
Medical Help
Other financial help, specify
Explain how and why the person in need of help is destitute and desperate
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Has a request for help been made to any other person or organization?
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If funds are requested, provide full details of amount needed and how funds will be spent
Documents Upload: Upload any documents to show the funds needed and how they will be spent
If you are requesting a loan, amount of loan needed
Please specify how and when loan will be repaid
Please provide details of persons/referee who could support your claim below, if any
Reference 1:
Name
Address
Mobile Number
Reference 2:
Name
Address
Mobile Number
How will you serve the community when you are able to?
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Documents Upload
Passport size photo
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Signature
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I agree
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I hereby waive UNITED SIKHS, its staff and volunteers and its agents, partners or associates from any liability of injury, loss or damage in all circumstances that may arise from the support I have requested above. I acknowledge that I understand the waiver described in this document. This waiver is made to the maximum extent permissible under applicable law. I acknowledge that I have signed this document under my own free will. I affirm that the information I provide is true and accurate to the best of my knowledge.
Note: UNITED SIKHS is a non-profit organization and relies on public donations to fund our projects. While we make every effort to respond to all requests for help, it is not always possible to meet all expectations.
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