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Dear Supporter,

Thank you for your dedication to creating a positive impact in the community. Your referrals have the power to bring about meaningful change. Kindly take a moment to complete the straightforward referral form below, assisting us in connecting individuals in need with the valuable services provided by the United Immigrant & Refugee Communities of Vermont. Your contribution is greatly appreciated😊

The UIRC Client Referral Form

Please provide the requested information below and send it to us by clicking on the “Submit” button below.

Referrer Information:

Client Information:

UIRC of VT, INC. was established in response to witnessing the widening gap, on a daily basis, between immigrants and refugees in the state, and the existing agencies or organizations that are intended to support them.

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1205 North Ave Suite #13 Burlington, VT 05408
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Copyright © 2023 UNITED IMMIGRANT & REFUGEE COMMUNITIES OF VERMONT, INC. All rights reserved.

Dear Supporter,

Thank you for your dedication to creating a positive impact in the community. Your referrals have the power to bring about meaningful change. Kindly take a moment to complete the straightforward referral form below, assisting us in connecting individuals in need with the valuable services provided by the United Immigrant & Refugee Communities of Vermont. Your contribution is greatly appreciated😊

The UIRC Client Referral Form

Please provide the requested information below and send it to us by clicking on the “Submit” button below.

Referrer Information:

Your Full Name(Required)

Client Information:

Client's Full Name
MM slash DD slash YYYY
Gender(Required)
MM slash DD slash YYYY
Services/Programs Requested(Required)
Consent