Request Assistance – Ludus USA

Registration and Approval Form

Request assistance

Parent/ Legal guardian Name

First

Last

Applicant relationship to children

Telephone:

E-mail

Event Number

Address

City

State/Province

Zip/Postal

Country

Fill out information below on each child

Name

First

Last

Age

Date of birth

Gender

Add a child Remove

Requirement documents

Proof of parent or guardian
Proof of address (utility bills)
Proof of income

File Upload

Maximum file size: 516MB

By signing this document, I affirm and certify that all the information provide herein are
accurate and correct.

Read and accept

Donations and gifts received through this organisation are intended for charitable purposes only and cannot be resold or used for any commercial gain.

Signature

Clear

Ludus Usa will not share or sell your information
For more information:
Ludus.usa@yahoo.com
www.ludus-usa.org
+1 +774-417-7995

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