FUND FOR INDIGENOUS PEOPLES HUMAN RIGHTS DEFENDERS AT RISK
I. INFORMATION ON BENEFICIARY AND ASSISTING ORGANIZATION
For individual beneficiary/ies (to be filled up only if request is being made for individual/s)
(Add more lines if beneficiary is more than one)
Please provide a summary of the event that has prompted your request for assistance. Please attach a factsheet of the case.
Maximum size 10MB
Please check the box below for the assistance needed
In case the request for assistance is approved, please provide the bank account details where the grant will be sent:
1. Name of Account
2. Address of Account Holder
3. Account Number
4. Name of Bank
5. Bank Address
6. SWIFT CODE
Should any specific information about the request be kept confidential? AIPP does not disclose individual names and contact information to any party outside of the organization.
Signature of Beneficiary or Authorized Person with the Assisting Organization