Referral Form for Family Mentorship

The purpose of this form is to recommend resettled clients for Family Mentorship, which provides volunteers to a refugee family or individual.

A family mentor works individually or as part of a small team, to befriend a refugee(s) by providing regular ongoing support. The goal is to empower the individual or family to be self-sufficient. The mentor comes alongside as an advocate and friend, as the resettled person navigates their new home and accesses local resources like public transportation, grocery shopping and more.

  • Refugee Care Collective partners with all local resettlement agencies. This program is for R&P, ECM, and LCSNW PC-ICM and PIP programs. It is for those with current or prior refugee status, as well as for those from Afghanistan who were granted humanitarian parole.
  • Please fill out this form to the best of your ability. We will not contact potential clients without contacting you first.
  • This form is not for volunteers to do transportation or one-off requests. It is for long-term volunteers to support a family or individual for one year.

If you have not heard back within 48 hours, please email directly.

"*" indicates required fields

If this referral is for the whole family, please include the full name of the head of the family here + "Family." (Ex. Hussain Muhammad and Family.) If this is for an individual client, please only include the client's name.
Program Client Is Being Referred To:*
This helps us match volunteers. Include intersection or area of city if you don't have the full address. Include "Temporary Housing" if that's the case.
Month and year format.
Ex. Catholic Charities of Oregon, Ecumenical Ministries of Oregon, IRCO, Lutheran Communities Services Northwest
Please share to the best of your ability. Ex: Hassan Male 39, Amina Female 37, Fatima Female 4)
Has this person expressed interest in this program?*
Priority Level:*
Ex: New arrival, unable to attend English class because of young children, etc..
Level of English:
Only if referring from a resettlement agency. Ex: R&P, ECM, LCSNW PC-ICM or LCS PIP.
Please share as much information you are able to, at this time, about the individual or family.

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