Help Request Form

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Name *

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Last

yes, provide assistance

Phone Number *

Email *

Type of Assistance *

Select Just One.

Please briefly explain the assistance you require:

Please explain the reasons for requesting assistance: *

Have you ever received assistance from other organizations? *

If yes, please provide their name and contact information:

Is there another person who can verify your situation? *

If yes, please provide their name and contact information:

Baraka Development Foundation is a non-governmental organization committed to creating positive change and uplifting communities.