INFO LINE

1300 934 303

EMAIL US

info@houseofsadaqa.org.au

DONATE

Donate Clothes

Essentials Referral Request

Home Essentials Referral Form

To be completed by an organisation or individual registered with House of Sadaqa. Enquiries: bilal.fazli@houseofsadaqa.org.au

Referrer – Name(Required)
Email(Required)

Client Details

Name(Required)
Address(Required)
Country of Origin
Gender
Marital Status
Briefly provide details of client's circumstances (Pick more than 1 if applicable)(Required)

Client Essential Requirements

Please select from the following list according to client needs
Items Required(Required)
Please use extra comments below for quantities or other items not listed.
Do you need multiples of any of the above items or specify a size.

Essential Guidelines (To be discussed with the client)

HOS team is not responsible to remove any unwanted items already in the household. HOS team are limited to delivering HOS Essential Items and will assemble them where applicable.