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Application for funds

AMIS Application


Who is completing this form and we can reach out to for any questions?

Who is filling out this request?

(Whoever is filling out this form)

In case we have additional questions

If this referral is being submitted by an organization or agency

Immigrant Contact Information

Who will be receiving the funds?



Where are you from?

If applicable

If so, please indicate where.

If you have legal representation, please list the laywer's name and contact info (we may need more information or make a payment directly to them)

Funds Request

If the amount covers multiple costs, please list them.

Please list as much detail as possible to help us make our decision.

Example: rent assistance would benefit all who live in the apartment

If you are funded we will try our best to meet your timeline but there are no guarantees.

If so, please briefly summarize to help the board fully understand your financial situation.

Information such as: time in the US, how many family members are here/need support, legal or other financial considerations, etc.