FORM FOR FILING A CASE
Unit for the Rights of Children, Ministry of Women's Affairs & Social Security
Republic of Maldives


1. Information about the child

Name:									Age:
_ Male		
_ Female 
            Address (Island & Atoll):
            Present address: 
            Is the child at school?	
_ Yes
_ No
If Yes, 		Name of School:
Class:
            	If No, 		the reason for leaving school: 
            Number of children in the family:
            

2. Information about the child's parents

_ Married
_ Divorced
_ Mother deceased
_ Father deceased
Illegitimate child: 
_ Yes
_ No
Number of children the father has:
      Number of children the mother has:






3. Information about the father

Name:									Age: 
            Place of birth (including Island & Atoll):
            Registered Address:
            Present Address:
            Telephone no:


4. Information about the mother
Name:									Age: 
            Place of birth (including Island & Atoll):
            Registered Address:
            Present Address:
      Telephone no:


6. Information about the child's guardian
Name:									Age: 
            Place of birth (including Island & Atoll):
            Registered Address:
            Present Address:
            Telephone no:


7. Type of case
_ Stealing
_ Physical Aggression
_ Sexual Offence
_ Substance Abuse
_ Child Maintenance
_ Child Custody
_ Truancy
_ Anxiety
_ Child abuse victim (physical)
_ Child abuse victim (emotional)
_ Child abuse victim (sexual)
_ Other (please specify): 
8. Person filing the case
Name:							
            Present Address:
            Telephone no:
	Email Address:


Date:								Signature:



Please return the completed form to:

The Unit for the Rights of Children
Ministry of Women's Affairs and Social Security
Umar Shopping Arcade
Chandhanee Magu,
Male', Republic of Maldives