Seniors Africa Heritage Trip Fund Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeDate of Birth *Which Jamaat are you a member of? *BIRMINGHAMCOUNCIL OF SWITZERLANDESSEXGLOUCESTERHUJJAT LONDONHYDERI LONDONLA CHAUX DE FONDS SWITZERLANDLEEDSLEICESTERMARSTA SWEDENMILTON KEYNESPARIS NORTHPARIS SOUTHPETERBOROUGHTROLHATTAN SWEDENWATFORDWESSEXPLEASE SELECT How much money would you like to claim from the Seniors Heritage Fund? *£100£200£300Bank Details ( Sort Code)Bank Details (Account Number)IBAN (for bank accounts outside UK)BIC/ Swift (for accounts outside UK)What type of accommodation do you live in? *OwnedPrivately rentedSocial housingWhat is your employment status? *EmployedSelf-employedUnemployedRetiredHousewifeHow many dependants reside in your housing? *None12345more than 5Do you or any member of your household declared disabled? *YesNoI hereby declare as Allah (SWT) is my witness that I am a genuine applicant and all the information provided is true to the best of my knowledge. *Declaration of Truth (please tick)I hereby consent to The Council of European Jamaats to collect, use and store my personal data as required in accordance with the charity’s constitution and the Data Protection laws (including but not limited to the Data Protection Act 2018 and GDPR 2018) afforded by the governing laws of England and Wales. *GDPR Decleration (please tick)Submit
