Request a Toilet

Request a Toilet

Need a Toilet?

We will Help!

If you are in need of a toilet and are not able to afford one, we will try and help you. Please fill up the form below so that we can share the details with the corporates willing to donate the toilets against their CSR Budget.

Please note that it is not a guarantee or commitment from our side that you will get a toilet, but we will surely give it a try for you.

Toilet Request Form

Fill up the form below. All fields are necessary

Your Name
Your Email ID
Your Contact No
Name of Village / city
Name of District
Name of State
No of Toilet Users
Average Annual Family Income
Your Story/Message


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