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Help Request Form

This form is for requesting help from volunteers who are offering their time remotely. Please submit so we can match the right person as quickly as possible. If you're filling this in on someone else's behalf (like a friend in Gaza), that’s perfectly okay!

Name:

*

Age:

Preferred Contact Method:

*

Contact Details:

*

Approximate Location:

*

Help Request:

*

Details of Request:

*

🔒 Your information will only be shared with a trusted volunteer matched to help with your request. If you have any concerns about privacy, please let us know in the Details of Request section above.

Untitled checkboxes field

I understand and agree to share this information for the purpose of receiving help.

*