Advocate Form

Skip to content

(509) 863-9431

Monday – Friday 9 AM – 5 PM

Search:

Facebook page opens in new window Instagram page opens in new window

Safety Net Inland NW

Helping Teens From Foster Care to Adulthood

Home
What We Do
Get Involved
- Household Donations
Get Help
Blog
Events
Contact Us

DONATE

Home
What We Do
Get Involved
- Household Donations
Get Help
Blog
Events
Contact Us

Your form has been successfully submitted. Please send an email to admin@safetynetinlandnw.org, with the subject line "Request from "youth name or initials", and we will process your request as soon as possible. Thank you for connecting with us.

1

https://safetynetinlandnw.org/wp-content/plugins/nex-forms-express-wp-form-builder

false

message

https://safetynetinlandnw.org/wp-admin/admin-ajax.php

https://safetynetinlandnw.org/advocate-form

yes

1

fadeIn

fadeOut

Date

REQUESTED BY (Advocate Information)

*Name

*Phone Number

*Email

*State:

.

Washington

.

Idaho

.

Other

*Organization

*Title/Position

*Mailing Address

YOUTH INFORMATION

*Youth Name

*Purpose of Request (What is being requested):

*Time in foster care: Please check all that apply

.

Youth In Need (no time in foster care)

Aged Out

Adopted

Group Home

Reunited

In Foster Care

Extended Foster Care

* Please enter case worker name(s), organization(s), and phone number(s)

*Has the youth received help from Safety Net before?

.

Yes

.

No

If Yes is selected above, please provide a detailed list of all dates and assistance previously provided by SafetyNet Inland NW.

*Are you requesting access to shop the warehouse? SafetyNet does not currently offer delivery. Advocates and youth are responsible for transportation of any and all items from the warehouse.

.

Yes

.

No

*Which Warehouse?

.

Post Falls Warehouse

.

Spokane Valley Warehouse

*Are you requesting financial assistance?

.

Yes

.

No

*Payable to:

*Amount:$

*Address to mail check to:

*Upload the Youth's Personal Statement PDF

X

doc,docx,mpg,mpeg,mp3,mp4,odt,odp,ods,pdf,ppt,pptx,txt,xls,xlsx

Upload Supporting Document

X

doc,docx,odt,odp,ods,pdf,ppt,pptx,txt,jpg

Home
What We Do
Who We Help
Impact & Goals
Success Stories
About

Events
Get Involved
Referrals
Donate
Contact Us

Stay Connected

Phone: (509) 863-9431 Email: admin@safetynetinlandnw.org

Find us on:

Facebook page opens in new window Instagram page opens in new window

Subscribe to Our Mailing List

* indicates required

Email Address *

First Name

Safety Net is organized under the laws of the State of Washington and operates as a
tax-exempt entity under Internal Revenue Code 501(c)(3), tax ID #45-5010888.

Go to Top