MMIW/P Rapid Response Fund Application

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Indigenous Justice will prioritize program participants who meet the following eligibility criteria at the time of recruitment:

1. Tribally affiliated Indigenous Women/People who are survivors of violence/justice impacted
2. Individuals who are justice-impacted or survivors of violence;
3. Individuals who are very low-income (0-30% of Area Median Income) and, should funding allow, applicants deemed low-income (30-50% of Area Median Income).

While open to all who meet the above criteria, Indigenous Justice will prioritize those who are most in need. This includes but is not limited to: Missing and Murdered Indigenous women/ family survivors, LGBTQIA+/LGBTQ2S+ individuals, domestic violence survivors, those financially impacted by the pandemic, those disconnected from other benefits (i.e., justice-impacted individuals, individuals with experience of chronic homelessness, etc.), and individuals with disabilities.

Email *

Are you filling this request out for yourself? *

Yes

If an Advocate is helping with this application please list their name here:

Amount of Funds ($$) being requested?.

Purpose of rapid response emergency support ($$) request? (how will the funds ($$) be used.) *

When do you need the Funds ($$) by?

YYYY

What is the preferred method of payment *

Zelle

CashApp

Venmo

ACH Bank Transfer

Gift Card

Required

Name *

Age

Gender Identity

Race *

American Indian/Alaska Native/First Nations

Arab/Middle Eastern

Asian/Pacific Islander/Native Hawaiian

White/Caucasian/European American

Black/African/African-Caribbean

African American

Latin/Latina/Latinx/Latin/Hispanic

Multi-Racial:

Other:

Tribal Affiliation

Do you have any Dependents? *

Yes

If, yes, how many dependents and what is your relationship to those dependents?

What is your current annual income? *

Address (Street, City, State, Zip) *

Email *

Phone number *

Thank You!

The MMIW/P team will contact you to hear your input about this grant and how it is supporting you. If you do not want to be contacted, please let the team know.

Please note that an application for support does not guarantee funding.

If you have questions please email: info@indigenousjustice.org

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