Application Form

Disability Support Application

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Application

Disability Support Application

Apply for disability support services and benefits.

Processing Time

30-45 working days

Fee

ZMW K0.00

Ministry

Ministry of Elderly Citizens, Disability and Gender Affairs

Personal Information

Full Name *

Email Address *

Phone Number *

National Registration Card (NRC)

Address

Application Details

Purpose of Application *

Type of Disability *

Disability Level *

Type of Assistance Required *

Required Documents *

National ID Copy *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

Medical Disability Assessment *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

Specialist Doctor's Report *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

Income Declaration *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

Guardian/Caregiver Details (if applicable) *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

Bank Account Information *

Accepted formats: PDF, JPG, PNG, DOC, DOCX (Max 5MB)

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