Upholding Humanity's Welcome Circle Interest Form

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Please read the information below carefully before completing this form:

Thank you so much for your interest in supporting Ukrainian refugees. Upholding Humanity is an interfaith coalition based out of Long Island that is supporting the resettlement of Afghan and Salvadoran refugees in Queens and Long Island. We are currently looking for additional volunteers who are interested in being matched with a family from Ukraine to support their resettlement by forming a Welcome Circle. We ask that individuals on the Welcome Circle for Ukrainian evacuees have at least 5 hours of availability per week. If you are not able to commit to 5 hours a week, please note in your form whether you would be interested being a general volunteer with Upholding Humanity by volunteering with other families we sponsor.

Please read and complete this form carefully. Our Project Coordinator, Maddy Donath, will reach out to you with volunteer opportunities. Please add her email address (maddyupholdinghumanity@gmail.com) to your address book or check your spam folder for her emails. If you have any questions or concerns while you are completing this form, please reach out to Maddy.

First Name *

Last Name *

Email Address *

Cell Phone Number *

Address *

Name of Church, Synagogue, Mosque or Community Institution (if applicable)

Please share how many hours a week you are available to volunteer: *

1-4 *Please choose this option if you have limited availability and are interested in being a general volunteer and volunteering with any Upholding Humanity family that needs support.

5-9

10-14

15-19

20+

I am interested in volunteering with individuals from: *

Ukraine *Must have minimum of 5 hours/week of availability.

Afghanistan

No preference

Can you commit to volunteering with the Welcome Circle until the family becomes self-sufficient? Please note that the weekly time commitment will decrease as the family transitions to independence within 6 months. *

Yes, I can commit to supporting the family to self-sufficiency.

No, I cannot commit supporting the family to self-sufficiency.

Other:

Please identify the specific areas where you can assist: *

Healthcare: I work/ have worked in healthcare, and understand the healthcare system. I can help refugees with finding healthcare, book doctors' appointments, understanding health insurance, and other medical related issues.

Education/ Children: I work/ have worked in education. I can help children enroll in school and serve as a resource to parents.

Education/ Adults: I work/ have worked in education. I can help adults enroll in continuing education.

Language Assistance: I have expertise with ESL/ ESOL and can help identify language resources or can tutor those in need I can help children enroll in school and serve as a resource to parents.

Employment: I have the ability to provide/ find employment for individuals

Financial: I can help families with budgeting and money management

Legal: I am a lawyer or have connections to pro bono/low cost legal support to help families navigate the immigration system

Social Work: I am a social worker or have experiencing enrolling individuals for public benefits and identifying community resources

Interpretation/Translation: I am fluent/proficient in another language besides English

Other:

Required

Do you speak any languages other than English? If so, please indicate which languages. *

Please note that our volunteers are asked to complete an online background check. Fingerprinting is NOT required. Upholding Humanity will cover the cost of your background check if you wish to be reimbursed. Please note that even if you have already completed a background check to volunteer for other refugee resettlement efforts, you will need to complete a new background check to participate in a Welcome Circle.

Please confirm that you have read this information and agree to complete the required background check.

Yes, I will complete the online background check.

No, I will not complete the online background check.

The cost of the background check is $15-$30. If you would like to be reimbursed for the cost of the background check, please send a screenshot of the receipt and your mailing address to maddyupholdinghumanity@gmail.com and a check will be mailed to you. Would you like to be reimbursed for the cost of the background check? *

Yes, I would like to be reimbursed and I will send my information for reimbursement.

No, I do not need to be reimbursed.

Other:

Please share any additional information that may be helpful below. This can include information about yourself and your areas of expertise or passion.

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