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PLEASE COMPLETE THE FORM BELOW, ENSURING TO GIVE AS MUCH INFORMATION AS POSSIBLE.

THE FORM WILL THEN BE PASSED TO THE PANEL FOR ASSESSMENT AND WE WILL GET BACK TO YOU.

PLEASE NOTE: YOU ARE REQUIRED TO GIVE AS MUCH INFORMATION AS POSSIBLE ON THIS FORM AND  FAILURE TO DISCLOSE INFORMATION THAT IS LATER DEEMED TO BE IMPORTANT (e.g. health conditions) WILL INVALIDATE THE OPPORTUNITY FOR ANY POSSIBLE INVOLVEMENT WITH DNIPRO HOPE MISSION.

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WE NEED YOUR HELP FOR THE PEOPLE OF UKRAINE

We couldn't do want we do without the support of people like you.

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