Recipient Details
Personal information
Tell us who needs support and how donors or reviewers can understand the situation
quickly.
Full name Required
Country Required
Select your country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Select the country where the recipient resides.
Step 1 of 5
Continue to Story
Share your life story
This is the human part of your application. Help donors understand your daily reality,
the challenges you face, and why support matters now.
Personal life story Required
Include family circumstances, household size, work or school background, diagnosis,
emotional and physical impact, and the challenges you face each day.
0/10000
Back
Step 2 of 5
Continue to Assistance
What kind of help do you need?
Choose the category that best matches your situation, then explain the specific support
you are requesting.
๐ง
Adults, treatment & support
Medical treatment, medication, rehabilitation, or
recovery support for adults.
๐ง
Children under 18
Treatment, rehabilitation, therapies, medication,
or essential care for children.
๐จ
Emergency social aid
Urgent social support for critical situations,
sudden hardship, or family emergencies.
Specific assistance details Required
Be specific about what is needed, why it matters now, and how the requested
support will be used. 0/5000
Required donation amount Required
Enter the target amount needed to fund the requested support.
Service provider details Optional
Include the organization, clinic, or provider that will deliver
the assistance. 0/2000
Additional relevant information Optional
Use this space for context that does not fit naturally into the
other fields. 0/2000
Back to Story
Step 3 of 5
Continue to Documents
Final Confirmation
Publish your project on-chain
Your supporting documents and metadata are now prepared off-chain. Review the publication details below, then confirm the wallet transaction that creates the project contract.
Documents uploaded.
CareChain prepared an IPFS record for this application. The final publication step will ask your wallet to create the project contract.
Publication did not complete.
Review your wallet state, confirm you are on the expected network, and try publishing again.
Generated Donee Address
This address will receive the donations. Save the private key securely - it will be shown below.
Private Key (Save securely!)
Important: Copy and save this private key securely. You will need it to access donations. It cannot be recovered if lost!
Back to Documents
Step 5 of 5
This final step publishes your project on-chain using the prepared IPFS hash and funding target. As soon as you click Publish On-Chain, a transaction confirmation should appear in your wallet.
Publish On-Chain
Publishing On-Chain