Urgent assistance form - World Anti Extremism Network

First Name

Last Name

Gender

Date of Birth

Email Address *

Phone Number

City

State/Province

Country

Current Occupation / Organization

Write About Yourself: Your background, achievements, and why you faced with these challenges?0 / 180

Are you currently facing threats or have significant safety concerns? Or do you require other forms of support, such as financial assistance?0 / 180

What actions do you recommend we take in response to your case and what you need exactly from us?0 / 180

Do you seek evacuation to a safe country?

Is it emergency?

Please write the names and contact details of two references who should be well aware about your situation and works.0 / 180

Please write your social media platform links or any website that can describe your work and achievements.0 / 180

Feel free to add any additional information or comments.0 / 180

Please Upload: Photo, CV / Resume, Other supporting documents which can support your case and shows that you are under threats or needs the requested support

Only PDF, Word file, JPG and PNG are accepted and it should not be more than 8 MB

WAEN

Publications

Contact