Request Flood Relief Assistance

Fill in this form if you or your family are affected by the Assam floods. Our volunteers will review your request and reach out to arrange assistance.

Are you Assamese?

Personal Information

Full Name*

Phone Number*

Your Location

Village / Town*

District*

What Do You Need?

Select all that apply *

Quantity / Amount Needed*

Describe Your Situation*

Photo Verification

Geo-verification required: Please take a photo from your current location using your phone camera with location services enabled. The photo must contain GPS metadata as proof of being in Assam.

Geo-tagged Location Photo*

Assamese Identity Proof (optional)

Your personal information is kept private and only used to process your relief request.