The information provided in this application is true and accurate to the best of
my knowledge. I understand that any false, misleading, or incomplete
information may result in the rejection of my application or withdrawal of any
support granted.
I acknowledge that the submission of this application does not guarantee
approval or the provision of financial or medical assistance. All applications
are subject to review, verification, and availability of funds or resources.
I consent to the verification of the information provided herein, including
medical and financial details, and authorize the relevant parties to contact
healthcare providers, institutions, or referees where necessary for purposes of
assessment.
I further consent to the collection, processing, and use of my personal and medical
information strictly for the purposes of evaluating this application and
administering any support that may be granted, in accordance with applicable data
protection laws.
I agree to indemnify and hold harmless the organization, its officers, employees,
and partners from any liability arising from the use of the information provided or
from the outcome of this application.
