HIAS-PA Refugee Resettlement Donor Form
This form is to be used by donors of material goods to the Refugee Resettlement Program -- furniture, coats, household goods, etc -- as well as direct cash support. Your contributions are an important part of HIAS-PA's Refugee Resettlement Program and are deeply appreciated. We are also required by our funders to report this information, so filling out this form each time you donate to us is important. Please note that any purchases or services made on behalf of a client are entirely voluntary, will not be reimbursed by HIAS-PA, and will become the property of the client upon receipt.

If you've contributed your time working with our refugee clients, please track this in our Volunteer Database at https://app.betterimpact.com/Login/Volunteer

Your Name (last, first) *
Your answer
Email address *
Your answer
Date of donation (or date range) *
Your answer
Name of refugee client or family if donation is for use by a specific person or family. (Otherwise leave blank.)
Your answer
Description of donation (ie, 6 winter coats, 4 twin beds, one month rental assistance, groceries, etc.) *
Your answer
Please list or estimate value of above donation(s).
Your answer
I would like a donation receipt emailed to me.
Note for HIAS-PA staff (follow up needed, observations, etc.)
Your answer
Submit
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