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One Community Organization for Peace and Development
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Intake form
Help us serve you better
Name
*
Email address
*
What is your current location?
Select
Khartoum
West Darfur
East Darfur
Which group do you belong to?
Please select at least one option.
Women
Children
People with Disabilities
Community Leaders
Youth
What type of assistance do you seek?
Please select at least one option.
Peacebuilding
Capacity Building
Community Development
Advocacy
Emergency Assistance
How did you hear about us?
Select
Social Media
Word of Mouth
Community Event
Referral
What is your preferred method of communication?
Please select at least one option.
Email
Phone
In-Person
WhatsApp
Please describe your specific needs or concerns.
Which service or services are you interested in?
Please select at least one option.
Community empowerment programs
Peacebuilding initiatives
Support for vulnerable groups
<strong><span style="color:rgba(10, 4, 120, 1)">human rights</span></strong>
<strong>protection</strong>
<strong>Health </strong>
Additional questions or comments
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