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Apply for Assistance

If you are a scholar experiencing threats to your life, liberty or academic career, or if you have been forced to leave your country because of such threats, and would like to request help from SAR please complete and submit the form below.

Confidentiality: Information provided is treated as confidential and used only for the purpose of arranging help where possible, including visits to SAR Network member institutions. If you prefer not to use the online form, you may print and mail or fax it, or contact Scholars at Risk by telephone.

Step One: Complete Form Security
Is it safe for Scholars at Risk to contact you directly about your situation?
Yes. Please contact me directly.
No. Direct contact is not safe at this time. Please contact me through:
Contact Name	Contact Email or Phone Number
Please describe any specific concerns or instructions for communicating with you or your contact person.
Personal Information
Title / First Name * Mr.Mrs.Ms.MissDr.Rev.Prof.	Middle Name	Last Name *
Phone *	Mobile	Email *
Address
Address (cont.)
Address (cont.)
City		State/Province
Postal Code		Country * -n/a-AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)Congo; Democratic RepublicCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestine/Occupied TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent/GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamWestern SaharaYemenYugoslavia; Federal RepublicZambiaZimbabwe
M/F Date of Birth -n/a-MaleFemale	Marital Status -n/a-SingleMarriedDivorcedSeparated	Nationality
Languages: Please list the languages in which you teach, research or conduct your work:
English-fluent Needs English Training Arabic Chinese Farsi French	Italian Spanish Russian Urdu	Other. Please indicate.
Academic / Professional Information
Field / Discipline		Specialization
Highest Degrees
Degree type -n/a-BAPhDMALLMCertificateMScOtherMDMSBSMaster'sLLBMA+Advanced CertificateJDDiplomaMFApre-MA degreeMaster's-PhDNon-degreebogusPost GraduateMPAABDMPMBaccMD+B.Sc.post MS fellowshipDEA in processD. PhilMbCHb	Subject	Institution
Location	Start Date	End / Award Date
Employment
Institution / Organization	Location	Position
Start Date	End Date
Threat or Risk Information
Please indicate your current location:* -n/a-AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)Congo; Democratic RepublicCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestine/Occupied TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent/GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamWestern SaharaYemenYugoslavia; Federal RepublicZambiaZimbabwe
Please describe the threats or risk you are experiencing and the help you are requesting from Scholars at Risk: *
Help / Opportunities Sought
Timing Requested
Opportunities sought: Not Seeking Seeking 1-3 month teaching Seeking 3-6 months Seeking 6-12 months Seeking co-teaching Seeking research Seeking graduate study opportunity
Submitted by (if other than applicant)
Name	Email / Phone Number