This form is designed for individuals seeking financial assistance from Kindred Barakah. Applicants are required to provide personal information, details of their financial situation, and the nature of the emergency or crisis they are facing. Additionally, applicants are asked to provide information about their employment status, any medical conditions or disabilities, legal issues, and counseling or therapy they may be receiving. The form concludes with a declaration of the accuracy of the information provided and a signature section. Applicants are instructed to submit the completed form along with any supporting documents to Kindred Barakah for review.