AZSF - Application Form

What is your Religion? *

First name (as on your ID)*

Last name (as on your ID)*

Gender*

Date of Birth (as on your ID) *

Email address *

Telephone *

Address *

Country *

City *

Postcode *

What is your living status?*

How many children do you have?*

What is your current housing situation?*

Are you suffering from long term illness or disability?*

Have you applied to the Hardship Relief Fund before?*

What identification document do you hold or send "NIL"*

Upload your identification document *

Do you have a PayPal account?*

What is your current work status?*

Do you receive state benefits monthly?*

How much do you receive from state benefits monthly?*

How much money you have with you and in all of your bank account(s)?*

How much gold and/or silver savings do you have?*

How much do you owe in total, any debts and including gas or electricity bills?*

What is your monthly income?*

Do you pay for Rent, Mortgage or Council Tax each month?*

Briefly describe any financial challenge(s) you are currently facing*

Why do you need Zakat Help?*

Apply for Zakat Funds