Financial Assistance Application (SRVIC)
Dear Community,  Due to COVID-19 you may find yourself in need of assistance. Please do not hesitate to reach out to San Ramon Valley Islamic Center by submitting this application form.
For any questions with regards to this form, kindly email info@srvic.org
Once completed, we will get back to you within 24 hours.

Please Note: By filling out this application, you are confirming that all information provided is true and accurate.
Any incomplete ,duplicate, or fraudulent applications will be disregarded completely.
ALL INFORMATION IN THIS APPLICATION IS 100% CONFIDENTIAL.

Thank you
San Ramon Valley Islamic Center Management.

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Muska *
Sadat *
5050 Hacienda dr unit 1912 dublin ca 94568 *
4094348947 *
Smuska.sadat@ gmail.com *
Marital status *
Spouse First Name
Spouse last Name
I have two children  *
How many senior residents at this address? (65+)
Which Masjid do you most often attend?
Employment status (during COVID-19) *
Employment status (AFTER COVID-19) *
Do you need help with rent? *
$2600
Salam brother! I was a nanny and my kids moved and now I am jobles. All sudden happened and I don’t have a rent for next month. Please help me to pay my next month rent. Thank you 
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