1. Statement of Need

The Portland Peace Corps Association has established a special fund to support community members with crucial needs due to their evacuation and/or impacts from the coronavirus pandemic. This survey seeks CONFIDENTIAL information that will be used for award determinations.

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1. First please tell us who you are and how to reach you. (Required.)

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2. In which country and in which years did you serve in the Peace Corps?

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3. Were you affected by the 2020 worldwide evacuation of Peace Corps Volunteers?

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4. Today I seek help with...

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5. I seek the following level of assistance.

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6. Though support is not guaranteed, payment will be most prompt if you provide your Venmo ID in this box.

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