Help Inquiry
Solicitud de Apoyo

Nombre del Menor/Child's Name

Fecha de Nacimiento/Date of Birth:

Lugar de Nacimiento/Place of Birth:

Sexo/Sex:

Edad/Age

Actualmente va a clases/ still attending school?

Escuela/School:

Grado que cursa/grade of school:

Nombre de la madre/mother's name:

Lugar de trabajo/Work:

Ingreso/Income:

Nombre del padre/father's name:

Lugar de trabajo/Work:

Ingreso/Income:

Direccion/address:

Ciudad/City:

Estado/State:

CP/Zip:

Tel:

Tel Cel:

Como supo de la fundación?/how did you hear about the foundation?:

Condición de salud del menor/health condition of the child:

Diagnóstico/diagnosis:

Fecha del diagnóstico/Date of diagnosis:

Edad/Age:

Lugar del diagnóstico(clínica, hospital)/Place of diagnosis(clinic, hospital):

Ciudad/City:

Tratamiento requerido/Required Treatment:

Ayuda requerida/Help needed:

Costo/Cost:

Fotografía/Photography:
Types/Tipos: png | jpg | jpeg | gif
*Size limit/Tamaño máximo: 4MB

Documento/Document:
Types/Tipos: zip | rar | png | jpg | jpeg | gif | pdf
*Size limit/Tamaño máximo: 4MB
*To send multiple files/pictures please make a zip file.
*Para enviar múltiples archivos y/o fotos cree un archivo comprimido (zip)

Yoana Monserrat Parra

Posted in: Children & Youth |

Mexico Children’s Foundation has helped Yoana in the past with an eye prostheses needed as the result of an accident. She currently needs glasses for far-sightedness, as well as replacing her prosthesis due to an infection that has developed.

Written by Richard Scott

View all posts by: Richard Scott

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Yoana Monserrat Parra

Written by Richard Scott

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