Form Page: sponsorship

CHILD SPONSORSHIP FORM:

Instructions:

a) You MUST read through this form thoroughly and then carefully fill in the spaces provided.
b) This form MUST be filled in by the parent/guardian together with the child after understanding the information thereof.
c) It MUST be completed in BLOCK letters,submitted online and wait for your interview date-come with your copy.

BIO-DATA

Child:

Surname:

Other Names:

Date of Birth:

Age:

Place of Birth:

Nationality:

Religion:

BIOLOGICAL PARENTS:

Father:

Surname:

Other Names:

Date of Birth:

Age:

Place of Birth:

Nationality:

Religion:

HOME DISTRICT:

District:

Division:

Location:

Sub-Location:

Village:

Street:

Plot No:

Street:

Plot No:

Street:

Plot No:

Street:

Plot No:

Street:

Plot No:

Street:

AREA OF RESIDENCE:

District:

Division:

Location:

Sub-Location:

Mother:

Maiden Name

Other Names:

Age:

Date of Birth:

Place of Birth:

Nationality:

Religion:

HOME DISTRICT:

District:

Division:

Location:

Sub-Location:

AREA OF RESIDENCE:

District:

Division:

Location:

Sub-Location:

Are both parents alive?

Yes

If still alive, are they staying together?

Yes

(Tick where applicable)

ORPHAN STATUS:

Both Mother and Father died

Only mother died

Only father died

DATE OF DEATH:

Father

Mother

State the number of brother(s) and sister(s) in the family:

Brothers

Sisters

List their name(s) below with their corresponding ages:

PERSON / ORGANISATION THE CHILD IS STAYING WITH:

PERSON

Surname:

Other Names:

Relationship with the child:

AREA OF RESIDENCE:

District:

Division:

Location:

Sub-Location:

ECONOMIC STATUS OF THE PERSON STAYING WITH THE CHILD:

Nature of Employment:

Self-employed

Employed

If Self- employed, state:

i. Type of job/ Profession:

ii. Location of the Business:

iii. Postal address:

iv. Office Tel:

v. Mobile

vi. Income per annum:

If employed, state:

i. Type of job/ Profession:

ii. Name of Employer/ Company:

iii. Location of the company:

iv. Postal address:

v. Office Tel:

vi. Mobile

vii. Income per annum:

State the number of Biological children and Dependants being cared for by that person:

Number of Biological children

Number of Dependants

TOTAL

HEALTH OF THE CHILD:

Indicate any abnormalities or special cases of illness that the staff should be notified of, such as sickle cell anemia, asthma,AIDS, visual and hearing impairments etc

REQUIREMENTS:

a) 2 Photographs:

b) Letter from a guardian/parent appealing for a well-wisher/donor funding

c) Letter from Local church appealing for a well-wisher/donor funding

d) Letter from a government representative in your area

e) Certificates which are necessary e.g. Birth, Death etc.

REGULATIONS:

The child must whatsoever abide with the rules and regulations of the organization. Failure to comply, your BiLD CENTRE will not be responsible for the action taken by the against the child and in any case will lose the sponsorship.

DECLARATION:

I solemnly declare that I understand the aforesaid conditions and regulations and the information furnished in this form is true and correct to the best of my knowledge.

Signed by:

Child

Parent/Guardian

Organization