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 Reception and Placement (R&P) cases only. Clients must meet the following criteria:

  • R&P cases who will arrive in Oregon within the next 14 days, or have arrived within the past 30 days at the time of referral.
  • Families of 3 people or more, who live in their own home:
    • Parents with children under 18 years of age in the household.
    • A single parent with children under 18 years of age in the household.
    • Grandparents or legal guardians with children under 18 years of age in the household.
    • Elderly couples who cannot pursue employment.

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.

Criteria and guidelines for our Restart Kits Service can be viewed here.

Our team will be in touch with you, confirming the available Restart Kits for each client along with pickup information. Thank you for your work!

"*" indicates required fields

This name will be written on each Restart Kit.
(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:
Depending on inventory, 1 of each kit will be provided with the exception of up to 2 Twin Bedding Kits and 2 Queen Bedding Kits, depending on family size.
If you selected a Queen Bedding Kit, share how many the family needs.
We may not have this many Bedding Kits available. We will do our best to meet this need.
If you selected a Twin Bedding Kit, share how many the family needs.
We may not have this many Bedding Kits available. We will do our best to meet this need.
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We may not have this many Bedding Kits available. We will do our best to meet this need.
Hidden
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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