الاسم الأولعائلة*

اسم العائلة*

البريد الإلكتروني*

رقم الهاتف المحمول

الرجاء أدخل 00 يليه رقم الهاتف

البلد*

France MetropolitanTaiwanNone GivenBurundiDjiboutiEritreaEthiopiaKenyaComorosMadagascarMauritiusMalawiMozambiqueRunionRwandaSeychellesSomaliaUgandaMayotteZambiaZimbabweUnited Republic of TanzaniaAngolaCentral African RepublicCongoCameroonGabonEquatorial GuineaSao Tome and PrincipeChadDemocratic Republic of the CongoAlgeriaEgyptWestern SaharaLibyaMoroccoSudanSouth SudanTunisiaBotswanaLesothoNamibiaSwazilandSouth AfricaBurkina FasoBeninCape VerdeGhanaGambiaGuineaGuinea-BissauLiberiaMaliMauritaniaNigerNigeriaSierra LeoneSenegalTogoIndiaSri LankaMaldivesNepalPakistanIran (Islamic Republic of)UAEArmeniaAzerbaijanBahrainCyprusGeorgiaIsraelCote d'IvoireSaint HelenaAntigua and BarbudaAnguillaArubaBarbadosBahamasCubaCuraaoDominicaDominican RepublicGrenadaGuadeloupeHaitiJamaicaSaint Kitts and NevisCayman IslandsSaint LuciaSaint Martin (French part)MartiniqueMontserratPuerto RicoSint Maarten (Dutch part)Turks and Caicos IslandsTrinidad and TobagoChina, Macao Special Administrative RegionDemocratic People's Republic of KoreaRepublic of KoreaBrunei DarussalamIndonesiaCambodiaLao People's Democratic RepublicMyanmarMalaysiaPhilippinesSingaporeThailandTimor-LesteViet NamAfghanistanBangladeshBhutanIraqJordanKuwaitLebanonOmanOccupied Palestinian TerritoryQatarSaudi ArabiaSyrian Arab RepublicTurkeyYemenBulgariaBelarusCzech RepublicHungaryRepublic of MoldovaPolandRomaniaRussian FederationSlovakiaSaint Vincent and the GrenadinesBonaire, Saint Eustatius and SabaBritish Virgin IslandsSaint-BarthlemyUnited States Virgin IslandsBelizeCosta RicaGuatemalaHondurasMexicoNicaraguaPanamaEl SalvadorBermudaNew CaledoniaGreenlandSaint Pierre and MiquelonUnited States of AmericaArgentinaBrazilChileColombiaEcuadorFalkland Islands (Malvinas)French GuianaGuyanaPeruParaguaySurinameUruguayBolivia (Plurinational State of)Venezuela (Bolivarian Republic of)KyrgyzstanKazakhstanTajikistanTurkmenistanUzbekistanChinaJapanMongoliaChina, Hong Kong Special Administrative RegionUkraineLand IslandsDenmarkEstoniaFinlandFaeroe IslandsGuernseyIrelandIsle of ManIcelandJerseyLithuaniaLatviaNorwaySwedenSvalbard and Jan Mayen IslandsAndorraAlbaniaBosnia and HerzegovinaSpainGibraltarGreeceCroatiaItalyMontenegroThe former Yugoslav Republic of MacedoniaMaltaPortugalSerbiaSloveniaSan MarinoHoly SeeAustriaBelgiumSwitzerlandGermanyFranceLiechtensteinLuxembourgMonacoNetherlandsAustraliaNorfolk IslandNew ZealandFijiPapua New GuineaSolomon IslandsVanuatuMicronesia (Federated States of)GuamKiribatiMarshall IslandsNorthern Mariana IslandsNauruPalauAmerican SamoaCook IslandsNiueFrench PolynesiaPitcairnTokelauTongaTuvaluWallis and Futuna IslandsSamoaUnited States Minor Outlying IslandsChristmas IslandsNetherlands AntillesUNITED ARAB EMIRATESUnitedFrench Southern TerritoriesUnited StatesUnknownCanadaAntarcticaUnited KingdomKosovoBouvet IslandSerbia and Montenegro (former Yugoslavia) الرجاء اختيار البلد

خصوصيتكمن خلال تقديم هذه الاستمارة، تقر بأنك تدرك أن بياناتك الشخصية ستُستخدم بالتماشي مع سياستنا للخصو صية. يحق لك سحب موافقتك في أي وقت من خلال الاتصال بنا على: care@unhcr.org.