Request for someone else
Please Note
You need to fill in your details here
*
Name
*
Surname
*
ID Number
Telephone Number
Email Address
*
Residential Address
*
Closest District Office
Select an Option
Bellville
Bloemfontein
Boksburg
Carletonville
Centurion
Ellisras
Kathu
Klerksdorp
Lydenburg
Newcastle
Port Elizabeth
Richardsbaai
Rustenburg
Secunda
Vaaldriehoek
Welkom
Witbank
*
Other - Type of Assistance
Food
Blankets
Clothes
Other
*
How many people need assistance?
Select an Option
1
2
3
4
5
6
7
8
9
10
*
Ages of people
Member of
Solidarity
Helping Hand
Afriforum
Notes
I agree
Your personal information is protected under the Protection of Personal Information Act (No 4 of 2013). An agent from Helping Hand will be in contact with you shortly to further discuss your request.
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