Referral Form for Restart Kits

The purpose of this form is to request Restart Kits.

Refugee Care Collective partners with local resettlement agencies: Catholic Charities of Oregon, Ecumenical Ministries of Oregon, IRCO, and Lutheran Community Services Northwest.

This program is for R&P clients only.

The Restart Kit List can be viewed here. As long as we have Restart Kits in stock, we will provide one of each kit per request, with additional Bedding Kits for larger families.

Our team will be in touch with you, confirming the available Restart Kits for each client along with pickup information. Each kit will be labeled with the client’s name.

Thank you for your work!

"*" indicates required fields

For new requests, this name will be written on each Restart Kit. If this request 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.
(Catholic Charities of Oregon, Ecumenical Ministries of Oregon, IRCO, Lutheran Communities Services Northwest)
(Ex: 37 year old mom, 9 year old girl, 7 year old boy)
Restart Kits Needed:
We may not have this many Bedding Kits available. We will do our best to meet this need.
We may not have this many Bedding Kits available. We will do our best to meet this need.
If so, please include your best guess for the diaper size.
Could the client use any of the following support?
Please note the coat sizes and gender for each household member and the grade for each child in the comment box below.
Do you think this client would also benefit from volunteer support?*
Feel free to include anything else you would like us to know.

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