If you are an individual or part of an organization assisting a refugee, please see our Humanwire Organization Signup page.
The three main criteria to be considered for Humanwire are as follows: 1) you must truly meet the definition of a refugee, 2) we must be able to verify your identity, and 3) you must have never participated in persecution against anyone for any reason.
Due to the difficulties we may have in verifying your identity as an individual, it’s strongly recommended that you have an official registered organization, non profit, business or individual vouch for your identity by submitting the application form on your behalf.
Notes for Application Form Fields
Please enter the name of the refugee here. If the application is for a group of people, one member who is older than 18 should act as the liaison for the application. If the main applicant is under 18, the application should be signed and agreed-to by the applicant’s legal guardian. If there is no legal guardian over 18 to vouch for the applicant(s), please use the “Other Notes” section at the end of the application to explain. If you are filling out the form on behalf of a refugee, we will ask you for your name and contact information at the end of the form.
If the application is for one person, list the primary language. The “Other Languages” field should include any languages that the applicant could “get by ok with”, it does not require fluency. If the application is for a group of people, please use the “Other Languages” field to include all languages spoken by the group.
When did you flee your home?
If the exact date is uncertain or complex, pick an approximate date. If the application includes a group of people with different dates, include the approximate dates in the family section below when listing names and ages.
Why did you flee your home?
Please be as descriptive as possible.
Number of Children
The total number of alive children, even if the children are not currently living with the applicants.
Name, Age, Relationship of all people living with you
This includes all occupants of the living quarters (or group) including friends, non-family members or anyone living in the same group who are willing to participate and receive benefit in the campaign. If there is a family member or person that does not wish to participate, they can be marked as “Private” and Humanwire will not use their name during the campaign.
Name, Age, Relationship of all immediate family members NOT living with you
Family members listed in this section may have their names and details kept private if the applicant desires (please include the word Private when indicated).
UN Registration #
For applicants without a UN #, enter “Unregistered”, “Seeking” and/or “Unavailable”.
If the applicant is currently with no home please indicate as much information as possible on exact location. Consider marking location with GPS coordinates.
This is the address where the applicant lived before fleeing due to war.
Email, Phone Numbers, Contacts
Provide as much detail as possible primarily for Humanwire’s ability to communicate.
Education and Work Experience
The main purpose of this section is to help the sponsor consider a group of advisors and other ways to help provide support beyond monetary assistance. For example, if anyone in the group is savvy with computers, it might be possible that a campaign could help lead to a job in the computer industry. Thus, please be as descriptive as possible.
Needs & Wishes
Having long, detailed documentation will help Humanwire craft a more successful campaign. Please include wishes from any children.
What are 3 things you would like to have that you do NOT need?
Please elaborate on the “little things” (or big) they may be wished for, even if not at all needed. Children may want specific toys or family members may have certain “dreams” or services that are beyond “needs” in case Humanwire can help do more.
Please list all countries applied to, and countries that the applicant would like to apply to.
We want to know as much detail as possible about any medical conditions or services we can provide. The more information we know, the more effective we can be in potentially providing quality support.
Waiver & Signature
If you do not understand any part of the Waiver, please contact us at firstname.lastname@example.org for clarification. If you are an individual representing a refugee, please read out loud and be sure that the application terms are understood by all applicants before they sign. If the applicant is not physically available to sign the form, enter your name to attest that the applicant understands and agrees to the terms.
If you are filling out the form on behalf of a refugee, please enter your contact information.
If you have any questions, please email us at email@example.com.
Refugee Application [English]
Refugee Application [Printable version for field]
Refugee Application [Arabic]
Refugee Application [Printable version for field]
To use “field” forms off-line, 1) Select ‘Save As HTML webpage Only” and save this form to your computer, 2) open form on your browser without a connection, fill out form and then select “Print…” 3) For the printer, select “Save as PDF…” and save the file to your computer, 4) Regain an internet connection and Email PDF to firstname.lastname@example.org