CRISIS FUND APPLICATION

1. Date / Time *

Date

Time

2. I AM A (Which category do you belong to?) *

An Individual
A Business
A community
Other

3. CORPORATE AFFAIRS COMISSION (CAC) NUMBER *

3. Business Type *

Sole Proprietorship
Partnership
Limited Partnership
Limited Liability Company (LLC)
Non Governmental Organization (NGO)
Cooperative (Co-op)
Partnership

4. Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

5. Your Name *

First

Last

6. Email *

7. I am From Which Country? *

Nigeria
United States
Cameroon

I am from which state? *

8. How Where You Affected By the Current Crises? *

Share a little information about your situation.

9. Name of Witness (Someone who can verify your crises. This individual should be the head of your clan, a pastor, a lawyer). *

First

Last

10. Can We Call This Person? *

Yes
No

11. Email of person listed on #9 *

12. Phone Number of person listed on #9 *

13. Upload 3 pictures and copy of your business license (If you indicated you are a business)

Click or drag files to this area to upload. You can upload up to 4 files.

About Us

World Ebony Network (WEN) is dedicated to reinforcing the enduring and noble philosophies, principles, practices (3Ps) of our fore fathers and appreciating the good aspects of other heritages. Our mission helps us to achieve our 3 part vision: to plead the socio-economic causes of people of African ancestry; to reconcile the estrange cultural relationships of people of African ancestry; and to appreciate the good aspects of other heritages.

Resource Links

Contact Support Team
Membership Application Form
Volunteer Assignment Form
Non-Disclosure Agreement
Start A Chapter
Family & Community Support

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