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Sample Form: درخواست کمک از خیریه

خانواده‌ی نیازمند یا معرف: وضعیت خانوار، نوع نیاز و مدارک — محرمانه.

8 questions · Free up to 50 responses a month

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About this template

“درخواست کمک از خیریه” has 8 questions; 7 are required and 1 optional. Question types: Short text (1), Mobile number (1), National ID (1), Quantity / order (1), Multiple choice (1), Long text (1), Postal address (1), File upload (1). 5 ready-made options across 1 choice questions, all editable in the online version.

In the online version of this template

  • National IDs are checked instantly with the check-digit algorithm.
  • Mobile numbers are validated against the Iranian number format.
  • Attached files are stored with the response.
Related:Online form builderIranian national ID validator

Questions in this template

  1. 1.

    نام و نام خانوادگی *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    کد ملی سرپرست *

    (National ID)
  4. 4.

    تعداد اعضای خانوار *

    (Quantity / order)
  5. 5.

    نوع نیاز *

    (Multiple choice)
    • معیشتی
    • درمانی
    • تحصیلی
    • مسکن
    • جهیزیه
  6. 6.

    شرح وضعیت *

    (Long text)
  7. 7.

    نشانی *

    (Postal address)
  8. 8.

    مدارک

    (File upload)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
Download WordDownload PDF

Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “درخواست کمک از خیریه”.
  3. Change the questions as you like, publish the form and send the link.

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