IMANI AID BENEFICIARY APPLICATION FORM
ABOUT IMANI AID
Imani Aid is a registered 501(c)(3) non-profit organization which is completely managed by volunteers and unpaid staff. 100% of the funding provided into the care of Imani Aid is from our Muslim community members via donation. Imani Aid does not receive any government funding.
Imani Aid’s mission is to provide charitable resources, assistance, services, and support to needy and underprivileged Muslims in the greater Indianapolis area. Detail can be obtained at www.imani-aid.org.
Due to limited funding, Imani Aid will provide assistance as listed below.
The type of assistance Imani Aid helps with may include: Rent; Utilities; Bus passes; Vehicle repairs*; Medical bills*; and Education*.

*Subject to the provision of additional documentation and screening.

Items that Imani Aid does not offer assistance with, but are not limited to: Loans; Car payments; Vehicle insurance; Gift cards; Cable/Dish Network; Phone bills; Vehicle purchases; Internet bills; Airfare.
Confidentiality & Information Sharing Policy
To assess need, personal information will be collected by Imani Aid. Your personal information will be kept confidential in our file system. Hard copies will be disposed properly after 3 months.
Occasionally, Imani Aid will share general information with our affiliates (like other masjids) and donors. By signing this application, you are giving Imani Aid permission to share your general information. Information such as your Social Security, bank statement, lease and paystub will not be shared.

Application process:
• Urgent / immediate assistance that requires less than 3 days is not provided.
• The review and approval process period is 3 – 5 days.
• Each application will be reviewed by all board members of Imani Aid.
• Phone interview and / or face-to-face will be conducted with applicants.
• No cash assistance will be given out. All assistance will be paid directly to companies that you owe to (Example: Landlord, IPL, Citizen Group, repair shop, etc).
• References are required for Imani Aid to contact.


Waiver of Liability / Legal Responsibility
• By completing this form, you are authorizing Imani Aid to do a background check if necessary.
• Imani Aid has no legal obligation to assist any applicant at any given time. Imani Aid has the sole right to approve or disapprove any application without any reason.
• Once your application is approved, you hereby release Imani Aid and its affiliates, and their personnel (board members, volunteers, officers, and administrators) of all liability and responsibility in case of any type of injury / accident involving applicant and his / her family members.
• By signing this application form, you agree that in the event a legal action is brought against Imani Aid and its affiliates or any of their personnel, the party bringing the suit shall bear all legal and associated expenses incurred by the defendant.

Next
Never submit passwords through Google Forms.
This form was created inside of IMANI-AID. Report Abuse - Terms of Service - Additional Terms