Disability Assistance

Before providing your Personal Data, please read PAL Data Privacy Policy to understand which Personal Data may be collected from you, the purposes for collecting such Personal Data, the parties to whom your Personal Data may be shared, our security measures, and most importantly, your rights as Data Subject under the Data Privacy Act.

I have read and understood, and agree to the Data Privacy Policy, and I hereby give my consent to the collection, use, monitoring, disclosure, or transfer of my Personal Data in accordance with PAL Data Privacy Policy. I attest that I have the authority to fill-out this form on behalf of the person whose details are provided below.

Personal Information

Type of Assistance

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