IMIrJ Sanctuary Fund Application

IMIrJ Sanctuary Fund Application

The IMIrJ Sanctuary Fund provides monetary grants to support the organization’s (im)migrant justice work. This includes support for individuals and families and stipends for hosts negativley impacted by the immigration system.

Source of Funds

IMIrJ solicits funds from the community using various outreach methods. Donations to IMIrJ may be designated to fund the IMIrJ Sanctuary Fund.

Decision Making

Funds are granted based on current needs, priorities, and capacity. Applications are accepted from people who reside in Oregon only. We prioritize applications from organizations that we work with.

We try to respond to requests within one week of submission and send payment within ten working days of approval if the grant is approved. For large grant requests, a portion of the grant request may be approved.

Decisions made by IMIrJ are final.
Email*
example@example.com
Submission Date*

MonthDayYear
Date
Does this request require immediate action, Yes or No? Tell us the nature of the urgency so we can respond accordingly. Please tell us of any date requirements to receive funding. Be aware that the wait time for approved grantees is at least ten business days.*
Applicant's information

Below is information about the person applying and some details about the request. The Applicant and the Recipient may be the same person or organization. The Applicant is the person IMIrJ will work with if there are any questions about the request.
Applicant's Full Name*
Does the applicant represent an Organization? If so what is the organization's name?*
For example: ASST, PIRC, IMIrJ, DD-Direct Service or other organzation's name
Applicant's Email*
example@example.com
Applicant's Phone Number*
Please enter a valid phone number.
Funding Request ($) - Please be specific, stating the funds requested for the purposes below. We need a total dollar amount. If you are requesting funds for a hotel, rent, security deposit, or utility company, funds can only be paid directly to the utility, hotel or rental agency. For commisary payments we will need the A# and name of the person in custody entered at the end of the application in Other Disbursement Information. The maximum request you can make is $500.*
Funding Request. Maximum amount is $500
Type of Application*

Applying for an individualApplying for a familyApplying to support a host
Purpose of the funds*

RentHotel room expense - to be paid to hotelSupport of a host familyFoodCell phone costsUtilities to be paid to utility company: Provide company and account number in Other Disbursement InformationCommissary Fund at NWDC (max is $200): Provide name and A# in Other Disbursement Information
Why are you requesting a grant? - What is the situation? How will a grant help? Being specific will be helpful to IMIrJ in decision-making.*
Would you like to meet with one of IMIrJ's organizers to learn more about IMIrJ and opportunities for you and your family to engage?

YesNo
Recipient's Information

This section provides information about the grant Recipient. Who will receive the grant if approved? How will you receive the grant? If the request is for rent or hotel expenses, the recipient must be the rental agency of the hotel.
Recipient's Name - This may be the same name as the Applicant. If the applicant and recipient are the same, fill in the fields with "Same."*
Recipient info or Rental agency or Hotel
Recipient's Phone Number*
Recipient's email address*
example@example.com
Recipient's Family information - Total number of people in the household and the number of children or dependents.
Disbursement Address

If approved, we need to know how to deliver the grant. Provide the Recipient's Name Address City, State, Zip Code. If your request is for rental assistance, security deposits, or hotel room costs, the rental agency or hotel information, manager's name, and address must be listed here. If the request is for commissary money, please provide the recipient's name and A# in the "Other Disbursement Information" field. If the request is for utilities support, please include the utility company, account number, and zip code in the "Other Disbursement Information" field.
Full Name of Person who will receive the funds
Rental Agency or Hotel
Name of person who will receive funds*

First NameLast Name
Address*

Street Address

Apartment #

CityState

Zip Code
Other Disbursement Information

For commissary funds: A#, for Utility: account number and Zipcode
Enter account information to pay directly to utilities, phone, or A# to add to persons commissary account at NWDC
For commissary funds: A#, for Utility: account number and Zipcode
Any Other Information

Is there anything else you would like us to know?
Add any comments you consider important
Should be Empty:

Applicant's information

Recipient's Information

Disbursement Address

Other Disbursement Information

Any Other Information