PORTLAND REFUGEE SUPPORT GROUP
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PRSG  Financial  Aid  Request (Form B)

WARNING: If you use your smartphone to submit this form we may not receive it. Please use a computer. Thank you!

    Please allow 7-14 days for processing.​

    Volunteer Information


    Client Information

    Reason  for  request: 

    ​IF NOT, PLEASE CLICK HERE FOR RESOURCES

    Name and address of service provider: 


    Client  Details

    Please type "N/A" if a question does not apply to the client.

    Self-Sufficiency Plan


    Monthly  Expenses  &  Income

    Please type "0" if the amount is $0.


    Required Documents

    Bills:
    1. All bills related to the aid request 
    Expenses:
    1. Home lease/mortgage 
    2. Current utility bills
    3. Current proof of car payment plan
     (if client is leasing a car)​
    Income:
    1. Last 2 pay stubs from each working person (if applicable)
    2. SSI (if applicable)
    3. TANF (if applicable)
    ​4. Food Stamps (if applicable)​
    ​5. 2019 Tax Return
    6. 
    Last 2 
    bank statements until today's date
    Note that the we cannot considered the client's case without these documents. If you have any issues providing documents, please email yasser@pdxrsg.org. Thank you!
    ** By submitting this form, you are attesting that all information provided is true and correct to the best of your knowledge and that you are giving PRSG permission to speak to the service provider on your behalf in the event more information is needed.  To apply you must be a current or prior PRSG client. For questions, please email us at: info@pdxrsg.org
    *** PRSG reserves the right to deny assistance to any client based on misleading, false or insufficient information, or lack of funds. PRSG may contact a client or core volunteer at any time for further information if needed. PRSG does not discriminate on the basis of race, creed, color, ethnicity, national origin, religion, gender, orientation, age, height, weight, physical or mental ability, veteran status, military obligations, or marital status.​
    ∙ Make sure you click the SUBMIT button well, until you see the confirmation message "Thank you. Your information has been submitted" or you see the message "Please correct the highlighted fields".
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PRSG is a 501 (c)(3) nonprofit organization with Tax ID# 82-1924164 | Copyright © pdxrsg.org 2023
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    • Arabic عربي
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