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    Hifz Programme Child Details Form: Section I: Child Section

    Uploaded by

    fahru ihsan
    This document contains a child details form for a Hifz programme sponsorship. It collects information about the child's personal details, family situation, school/madrasa details, and economic circumstances to determine eligibility. It seeks information on whether the child is an orphan or from a needy family, their health, education status, family income and expenses. The form needs to be filled out and verified by a partner organization, and requires supporting documents like birth certificates and death certificates to validate information.

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    Hifz Programme Child Details Form: Section I: Child Section

    Uploaded by

    fahru ihsan
    21 views3 pages
    This document contains a child details form for a Hifz programme sponsorship. It collects information about the child's personal details, family situation, school/madrasa details, and economic circumstances to determine eligibility. It seeks information on whether the child is an orphan or from a needy family, their health, education status, family income and expenses. The form needs to be filled out and verified by a partner organization, and requires supporting documents like birth certificates and death certificates to validate information.

    Original Description:

    cdf

    Original Title

    CDF- kosong

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    This document contains a child details form for a Hifz programme sponsorship. It collects information about the child's personal details, family situation, school/madrasa details, and economic circumstances to determine eligibility. It seeks information on whether the child is an orphan or from a needy family, their health, education status, family income and expenses. The form needs to be filled out and verified by a partner organization, and requires supporting documents like birth certificates and death certificates to validate information.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    21 views3 pages

    Hifz Programme Child Details Form: Section I: Child Section

    Uploaded by

    fahru ihsan
    This document contains a child details form for a Hifz programme sponsorship. It collects information about the child's personal details, family situation, school/madrasa details, and economic circumstances to determine eligibility. It seeks information on whether the child is an orphan or from a needy family, their health, education status, family income and expenses. The form needs to be filled out and verified by a partner organization, and requires supporting documents like birth certificates and death certificates to validate information.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3

    Hifz Programme Child Details Form

    Ref: name of country/ no of form

    Criteria:
    - Orphan, max 12 years old (birth certificate) - Orphan (father’s death certificate)
    - Learning & memorizing Al qur’an (at least 1 juz) - Fakir/miskin (poor) family

    Section I: Child Section


    Name:

    First Name Middle Name Surname

    Sex: M F
    Date of Birth (dd/mm/yy):
    Nationality:
    Religion:.
    Address Line 1:
    Address Line 2: Picture
    City/ District:
    Country:

    Is the child?
    Orphan: Yes No Medical Information:
    General health: Poor Good
    Needy: Yes No If condition is poor, give details;

    With a disability: Yes No

    Kind of disability: -

    Is the child receiving a sponsorship/ financial support from any other organisation?
    Yes No
    If yes, Name of organisation:
    Full Address:
    Name of Representative:
    Tel no:
    Amount of financial support per month/ year: N/A (in kind)
    What does it cover? Education Health Food Clothes Other

    School/Madrasa Information:
    Name of school:
    Full Address :
    Tel No:
    Type of School (ex: Government, Private): Private
    Grade/ class Attending:
    Does the family pay school fees? Yes No
    If yes, what are the School Fees per month: IDR /month

    Section II: Family Section

    1
    Father’s Name:

    First Name Middle Name Surname


    Father’s work: -

    Date of death, if applicable: Cause of death:

    Mother’s Name:

    First Name Middle Name Surname


    Mother’s work:

    Date of death, if applicable: Cause of death:

    Who is taking care of the child? Parent Guardian

    If Guardian,
    Guardian’s name:

    First Name Middle Name Surname


    Relationship to child: (Uncle/Grandmother etc) Guardian’s work:

    Guardian’s address

    Number of brothers and sisters:

    Names and ages of brothers: Names and ages of sisters:


    1. 1.
    2. 2.
    3. 3.
    4. 4.
    5. 5.

    Do any of the sisters/ brothers receive any sponsorship from Muslim Aid/ any other organization?
    Yes No

    If yes, How many children are receiving sponsorships in the family -

    Name of sponsor/ organisation -

    Average Total Monthly Income: IDR Per month (uncertain)

    Is the family eligible for Zakah payments? Yes No

    Is the family receiving any financial assistance? Yes No

    If yes how much -

    Section III: Relevant Information

    State any information about the child/ family?


    - Health problems

    - Economic situation of the family


    .

    2
    - The child’s school progress/Hifz progress (how many Juz completed/How many years remaining till
    completion of Hifz?)

    - Expenses required by school/Madrasa?

    - What will the sponsorship funds cover?

    Declaration: (From partner organisation / Field Office) For office use

    I herby confirm that the information provided in this Date approved:


    application has been verified by our organisation:
    Child ID:
    Name of Organisation: YKMI Yogyakarta
    Comment:
    Address:

    Prepared by, Acknowledged by,

    Signature
    Date
    Supporting documents (please tick in the box the documents that you attached to the CDF)

    Birth certificate (obligatory)


    Parents/ guardian IDs (obligatory)
    Death certificate/ father (obligatory)
    Death certificate/ mother
    Medical report
    Consent form

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