Referral Form for The Brave House
This form is for attorneys, social workers, and other advocates in NYC who would like their client to become a member of The Brave House community! Once we receive a referral, we will begin our intake process with the young woman and welcome new members into the sisterhood as our capacity permits.

Your client is eligible to join The Brave House if:
1. They are between 16-24 years old;
2. They identify as female or are gender-non-conforming;
3. They were born outside of the United States;
4. They are survivors of some form of gender-based violence, including sexual, physical, and emotional abuse, threats, harassment, and economic/educational deprivation.

We offer a wide range of free services, including:
- Immigration legal support (on case by case basis for those under 21)
- English lessons
- Career advising / resume writing
- Art therapy
- Mindfulness & meditation
- Dance class
- Self-defense class
- Indoor rock-climbing
- College campus tours
- Museum visits
- Mentorship program
- Health insurance clinics
- and more to come! :)

Our workshops and classes are held in Brooklyn (Clinton Hill / Fort Greene), just steps away from the C train and a 10 minute walk from the Barclays Center, in a beautiful trauma-informed space for large groups. Our workshop space has pet bunnies. Our office is located at the Urban Justice Center at 40 Rector Street, New York, where we hold our smaller meetings and conduct our intakes. All of our services are free to members, and in return we ask that all members commit to attend at least 1 event per month in the spirit of building community, consistency and friendship. [NOTE: Due to Covid-19 all of our events are currently virtual]

If you're filling this out, it means you are dedicating your time and energy to helping someone. THANK YOU for being awesome. Now let's dive into how we can work together to provide as much support to these young women as possible.
Email *
What is your name & relationship to the young woman? (Ex: Name, Attorney) *
What is your e-mail? *
What organization are you a part of? *
What is the young woman's first name & last initial(s)? (Ex: Maria R.S.) *
How old is she? *
What country was she born in? *
What language(s) does she speak? *
Required
What county does she currently live in? *
Does she currently have legal representation?
Clear selection
What type of immigration case does the young woman have? *
Is she in removal proceedings? *
What service/class are you most interested in having her participate in? *
Did you already speak to the young woman about our services? *
Please provide a phone # or e-mail for the young person so that we can get started! *
Is there anything else you would like us to know before we reach out to her?
Do you have any ideas for programs / collaborations?
A copy of your responses will be emailed to the address you provided.
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