Site Application

Primary Contact
Please provide information about who we should contact to discuss opening an Immigrant Hope site.
Name
First Last
Email
Phone
Host Church
Please provide information about the church that would like to start an Immigrant Hope site.
Church Name
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email
Website
Pastor's Name
First Last
Denomination
Site Location
Please provide information about where the Immigrant Hope site would be located.
Do you plan to locate the Immigrant Hope site at the host church?
Select "No" if the site will be located at another church, in an off-site church-owned property, in a community center, etc.
- Yes
- No
- Not sure
Location Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Describe the location
Type of property, relationship to the host church, distance from the host church, etc.

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Partners
Please list any other churches or organizations that plan to partner with you to open and run the Immigrant Hope site.
Launch Team
Please provide information about the people who will work together to launch the Immigrant Hope program.
Is the leader of the launch team the same as the primary contact listed above?
- Yes
- No
Launch Team Leader
First Last
Launch Team Leader Phone
Launch Team Leader Email
Launch Team Leader Church
Launch Team Leader Occupation
List other members of the launch team
Name Email Church Occupation
Legal Workers
Please provide information about the people who will become certified (DOJ accredited) to provide legal advice at the Immigrant Hope site.
List legal workers at your site
Under 'Funding', please indicate whether the legal worker will be paid by the Immigrant Hope site, paid by the church or other organization, or work as a volunteer.
Name Email Funding
List training and experience for legal workers
Please list any training or hands-on experience with immigration law completed by the legal workers listed above.
Worker Name Training Title Training Provider Date
Volunteers
How do you hope to recruit volunteers to work at the Immigrant Hope site?
Volunteers can assist the legal workers as case managers, office assistants, spiritual care, prayer team, promotion, etc.

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Primary Contact

Name	Email	Church	Occupation

Name	Email	Funding

Worker Name	Training Title	Training Provider	Date

Organization	Specialty/Focus	Distance from your location