We are providing an application form in this portal for the patients.One could simply fill the form and mail us instantly to womenswelfaresyndicate@gmail.com.We shall get back to the concerned post profile verification which is systematically done by our volunteers.

The application form is available in both Tamil and English.For those who find it difficult to understand and write english can download the form in Tamil.

Kindly note the fact that application form doesn't guarantee funding instantly.Further process shall be intimated by our volunteers through phone.All expenditures involved for the treatment of the victim is subjected to availability of funds and hospital's support.At the same point of time, Women's Welfare Syndicate is not liable to bear the entire expenditure incurred.Kindly do the needful in case of shortage of funds.

Kindly DOWNLOAD FORM IN TAMIL (OR)
Kindly DOWNLOAD FORM IN ENGLISH