Via the form below, you can submit your application to be eligible for a defibrillator subsidised by the Saving Lives Foundation.
Make your motivation clear as to the reasons why you are applying, how you would benefit from having a defibrillator and why you would like us to consider your application.

Your application will be assessed on the basis of this motivation.

    Thank you for your application!

    Your application will receive our utmost attention. You will hear from us as soon as possible.

    All donations are welcome!

    With your help we can make as many defibrillators as possible available, so that as many lives as possible can be saved. Don’t hesitate, make a donation now!