Responsible Organization
Middle East Council of Churches (MECC)
Palestinian Refugee Service Department – Gaza
Purpose of the Form
To collect accurate information about children under five years old in Gaza in order to assess malnutrition cases and determine the need for nutritional or medical interventions. This helps direct assistance effectively to the most vulnerable families and ensures timely health and nutrition support.
Required Information in the Registration Form
• Father’s full name.
• Father’s ID number.
• Mother’s full name.
• Mother’s ID number.
• Child’s full name.
• Child’s ID number (optional).
• Child’s date of birth (under 5 years old).
• Contact mobile phone number.
• Place of residence near the clinics (such as: Al-Zaytoun, Shuja’iyya, Al-Tuffah, Al-Daraj, Al-Rimal, Al-Jalaa, Al-Sabra, Tel Al-Hawa, Al-Nasr, and surrounding areas).
Important Notes
Please ensure that all information is entered accurately to facilitate assessment and communication.
The program targets children under five years old who may suffer from malnutrition.
It is preferable that the residence is close to the listed clinics to ensure easier access to services.
You may be contacted via the provided mobile number to schedule assessments or provide assistance, so please ensure the number is correct and active.
