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Request for Financial Support (SALIS Members)
* Indicates required question
Name of the Requester
*
Your answer
Email Address of the Requester
*
Your answer
Mobile Number of the Requester
*
Your answer
Address of the Requester
*
Your answer
For whom the Financial Support is required for
Name
*
Your answer
Designation
*
Your answer
Institution
*
Your answer
Is He / She is SALIS member
*
Yes
No
Details of Family Members
*
Your answer
Category of Financial Support
*
Death
Hospitalized
Post COVID
Mobile numbers of Family members
*
(May be Husband / Wife / son / Daughter)
Your answer
Submit
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