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CONTACT FORM

Select your Language / Choisissez votre langue / Seleccione su idioma / Selecione seu idioma / Dooro luuqadaada / Pôna monoko nini olobaka malamu / حدّد لغتك / ជ្រើសរើសភាសារបស់អ្នក៖

Please select one:

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IMPORTANT PLEASE NOTE

IMPORTANT:

Due to staffing issues, we are closed to new cases until July 8, 2024.

You may be able to find information to help you on our Legal Assistance page or you can find information about other Legal Aid Resources in Maine.

-----Please do not fill this form out now-----

If you aren't able to find other help, please come back to this form
on or after July 8, 2024 and we'll get back to you as soon as possible. Thank you!

IMPORTANT PLEASE NOTE

Due to a large influx of Build HOPE applications, we are not able to get to everyone as quickly as we would like, but are working on processing each application in the order in which it was received.

Please be patient with us as we work towards getting each applicant the assistance that they need as quickly as possible.

IMPORTANT PLEASE NOTE

Due to limited staff capacity we will be unable to process new Build HOPE applications from June 28th-July 5th. You are welcome to apply during this time, but know that applications will be processed in the order in which they were received starting July 8th.

Thank you for your interest in employment at Maine Equal Justice! Please use this form to be notified when we post a new job. Click here to see current openings.

Contact Info

If you are requesting legal help for someone else, please provide us with your contact information. We will be in touch to discuss the issue with you before we speak with them.

First Name

Last Name

Pronouns

Preferred Pronouns:

Company / Organization (if applicable)

Job Title (if applicable)

Mobile/Cell Phone

Address

City

State

Zip Code

Prénom

Nom de famille

Numéro de téléphone auquel on peut vous joindre

Adresse courriel si vous en avez une

Ville

State

Code postal

Avez-vous besoin d’un interprète ?

Choisissez une langue :

Kombo

Kombo ya mboka

Numero ya telephone pona kozwa yo

Email soki ozali na yango

Mboka ovandi

State

Zip Code

Ozali na bosengi ya interprète?

Pona munoko nini olobaka:

នាមខ្លួន

ត្រកូល

លេខទូរសព្ទដែលអាចទាក់ទងអ្នកបាន

អ៊ីមែល ប្រសិនបើអ្នកមាន

ទីក្រុង

State

លេខប្រៃសណីយ៍

តើអ្នកកំពុងបំពេញទម្រង់នេះសម្រាប់អ្នកផ្សេងទៀតមែនទេ?

ជ្រើសរើសភាសារបស់អ្នក៖

الاسم الأول

اسم العائلة

رقم الهاتف حيث يمكن الاتصال بك

عنوان البريد الإلكتروني إذا كنت تملك واحداً

المدينة

State

الرمز البريدي

حدّد لغتك:

هل تملأ هذا النموذج بالنيابة عن شخص آخر؟

Primeiro nome

Sobrenome

Número de um telefone em que você pode ser encontrado

Endereço de e-mail, se você tiver.

Cidade

State

Código Postal

Você precisa de um intérprete?

Selecione seu idioma:

Primer nombre

Apellido

Número telefónico donde podemos contactarlo

Correo electrónico, si tiene uno

Ciudad

State

Cód. postal

¿Necesita usted un intérprete?

Seleccione su idioma:

Magaca koowaad

Magaca Dambe

Lambarka teleefanka oo lagugu la soo xiriiri karo

Email haddii aad leedahay mid

Magaalada

State

Nambarada Boostada / Zipkootka

Ma u baahan tahay turjubaan?

Dooro luqaddada:

Demographic Info - HOPE

I affirm that I am currently enrolled in one of the following programs:

*You may qualify if you are receiving TANF and attending an approved training or education program at least half-time. If you're not sure if you are attending an approved program please fill out the form and our staff will discuss that with you.

NOTE: If you are not currently enrolled in one of these programs please go back to the top and select "I Need Help" to request assistance.

If you're not sure and would like to learn more about the Build HOPE Project before applying, please click here.

Gender

How do you identify?

Race

Ethnicity

Immigration Status

Date of Birth

Annual Income

Relationship Status

Total number of children under 18 in the household

How many of these children are under 6?

Number of Adults in Household (other than you)

Are you the Head of Household?

To qualify for head of household (HOH) tax filing status, you must file a separate individual tax return, be considered unmarried, and have a qualifying child or dependent. The qualifying person must generally be either a child or parent of the HOH. The HOH must pay for more than one-half of the qualifying person’s support and housing costs.

Optional Demographic Info

Please note: The following questions are not required; you can choose not to answer. At Maine Equal Justice we want to make sure that we are providing services to the most vulnerable individuals and communities in Maine, including black, indigenous and people of color. It is helpful for us to collect this data to evaluate our outreach efforts.

Gender (optional)

How do you identify?

Race/Ethnicity (Optional)

Race

Ethnicity

Immigration Status (Optional)

Case Info

What kind of help are you looking for?

Other

Please include a brief description of the problem

Date of Birth

Training Info

Thank you for your interest in scheduling a training session with Maine Equal Justice (MEJ)! We accommodate training requests as our capacity and staff availability allow.

Please provide us with as much information about your requested training as possible. Once your training request is received a staff member will contact you to work out any details.

MEJ counts on individuals and organizations to pay for training services so that we can offer these events. The table below indicates our suggested fees. These fees are based on MEJ’s average cost to provide training services. We recognize that organizations have varying abilities to pay.

We do not want cost to be a barrier, so please let us know if the fees pose any difficulty in scheduling a training event. If you are able to pay, we will send an invoice once the workshop is confirmed. We value and welcome your participation.

Suggested Fees (based on the size of your organization's operating budget)	Training up to 2 hours	Half-day Training
Budget up to $75,000	$75	$100
Budget between $75,000 - $200,000	$125	$175
Budget between $200,000 - $500,000	$175	$250
Budget over $500,000	$275	$375

Your Organization's Operating Budget

Up to $75,000Between $75,000 - $200,000Between $200,000 - $500,000Over $500,000

Length of Training

Up to 2 hoursHalf day

Ability to pay

We can pay the above amountWe would like to discuss alternative payment arrangements

Would you prefer virtual/Zoom or in-person?

Virtual/ZoomIn-person

On which topic(s) are you requesting training?

Advocacy SkillsFood Supplement BenefitsGeneral AssistanceHealth CareHousingImmigrant Access to Safety NetLegislative UpdateSafety Net OverviewTANF/Aspire/PaSOther

Event (if applicable)

Preferred Training Date

We would like to know the approximate date and time that you would prefer to have this training. We will do our best to accommodate, and will work with you to find a date and time that works for everyone.

Preferred Training Time

Expected # of Attendees

Audience (service providers, attorneys, seniors, etc.)

Equipment Available Onsite

Equipment Needed

Accessibility Issues (ADA accessible, language access, etc.)

Internship Info

What is your interest area?

Timeframe requested

Level of study

How many hours are you looking for?

Expected goal or outcome of this internship?

Case Info - Build HOPE

The Build HOPE Project provides financial assistance to families participating in HOPE or Parents as Scholars to help people meet their needs and achieve their goals.

The Build HOPE Project is also about learning about the difference this financial help can make for families and how policymakers can improve safety net programs.

If you are a HOPE or Parents as Scholars participant, you are eligible to receive financial assistance from the Build HOPE Fund to help meet your family’s needs. Please complete the questions below and we will follow up to set up an appointment with a member of our legal services team to assist you.

NOTE: If you are not currently enrolled in HOPE or Parents as Scholars please go back to the top and select "I Need Help" to request assistance. Thank you.

How did you learn about the Build HOPE Project?

Other

Institution or Program you are attending:

Degree or certification program enrolled in:

Expected date of completion:

Please use mm/yy format. For example, for May 2023 please enter 05/23.

Programs or Services that you are presently receiving (check all that apply)

TANFSNAP (Food Stamps)MaineCareGeneral AssistanceEmergency Rental Assistance ProgramPublic HousingSection 8 VoucherOther Subsidized HousingLIHEAP (Heating Assistance)Pell Grant or Federal Student LoansWork-StudyChild Tax Credit (CTC)Expanded Earned Income Tax Credit (EITC)Other (please specify)

Other Programs/Services:

Student Debt

What kind of student debt do you have?

Federal student loansPrivate student loans Loan from school/institutionOther bank loan (personal/mortgage)Loan from family or friendI paid tuition with a credit cardNo student debt

Federal Student Loan Amount

Private Student Loan Amount

Amount Owed to School/Institution

Other Bank Loan Amount

Tuition Paid on a Credit Card

Amount Owed to Family/Friend

Total Student Debt

What are you seeking a grant from Build HOPE to pay for?
(Check all that apply and please feel free to choose “Other” if none of the options listed fit for you. Assistance is not limited to the items on this list.):

Child care/before or after-school programs Computer equipmentCounseling/therapy/substance use services Dental care Education supplies or equipmentElectricityEmployment assistanceEye careFood Health care Heating assistance Housing InternetPhoneTransportation TuitionOther: (Please be as specific as you can.)

During the phone interview you will be asked to tell us how much money you are requesting. Please be prepared to provide an estimate of how much you are asking for to meet your financial need.

Please describe the other things you need to pay for:

What circumstances happened that prompted you to need to apply for a Build HOPE grant (Check all that apply)

Had to go to a food pantry, a food bank, or a food site Skipped meals to save food money Lost day care Day care cost increaseBefore/after-school program costUnable to afford medical help for self, child, or partner/spouseUnable to afford dental help for self, child, or partner/spouseUnable to afford counseling/therapy/substance use services for self, child, or partner/spouseUnable to afford eye care for self, child, or partner/spouseHave fallen behind on rent or mortgageHave been evicted Had to go to a homeless shelter Moved in with a family or friends Received a notice that utilities would be shut offHad utilities cut off Had phone shut offHad fallen behind on car payments Had other transportation problems including car registration, repairs, inspectionsLost family income (job loss, child support, etc.)Borrowed money from a friend or relativeEducation support – equipment, books, clothesInternet hook-up costs or installationEmployment assistance – training, clothesLost/stolen/broken computerOther (please explain)

Please describe the other circumstances that prompted your needing funds:

Is the problem that you are seeking assistance for: (select one)

Did you seek other resources or funding prior to applying for this grant?

Are there other programs you were aware of that may have helped your situation? If so, why did they not help?

To move forward with processing your request for assistance from the Build HOPE Fund you will need to have a phone interview with a member of the Maine Equal Justice team. Once this request is received a team member will contact you to schedule a time for that interview. The interview should take approximately 35-45 minutes. What is the best way to contact you to schedule the interview?

If you would like to be contacted via a phone or email address other than the one listed above please enter that here:

What are the best times for you to meet with a member of the Maine Equal Justice Team? (Check all that apply)

Monday morningsMonday afternoonsTuesday morningsTuesday afternoonsWednesday morningsWednesday afternoonsThursday morningsThursday afternoonsFriday morningsFriday afternoonsI can’t talk on the phone during 9-5 business hours

If you do not hear from us within 5 business days there may have been a technical issue with the submission of this form. Please reach out to buildhope@mejp.org

Peer Workforce Navigator Project

Maine Equal Justice is part of the Maine Peer Workforce Navigator project. This project works to connect community members to good, quality jobs and opportunities for education and training.

Would you be willing to be included as part of this project? This means is that your name and information would be passed on to the Maine Department of Labor so that they can keep track of how this project is helping people access good-paying jobs over time.

YesNo

Thank you. Your demographic information and date of birth are collected because:

We know that some communities and community members in Maine experience barriers to public benefits and services. We collect demographic data to ensure that our work is serving these communities.

This is a pilot project. We need data to prove that our services help people overcome barriers to getting public benefits and services and ultimately, help community members to meet their education and employment goals.

Your individual confidential information will be accessible only to the Peer Workforce Navigator Project and the Maine Department of Labor. The only information shared publicly will be overall results of the project.

Do you agree?

YesNo

Please enter today's date:

What is your employment status?

What is your hourly wage?

Do you have a Maine JobLink account?

Are you getting unemployment insurance benefits right now?

YesNo

Thank you! Please click this link to go to our donation form. We appreciate your support!

Communication Preferences

I would like to join the email list

I'm interested in volunteering

Please do not email me

Please do not text me

Which issues are you interested in?
(Check all that apply)

Improving DHHS servicesVoting RightsConsumer RightsDentalEarly Care and LearningEducation/TrainingUnemploymentGeneral AssistanceHealth CareHousingFood AssistanceImmigrant AccessIncome Supports for Low-Income FamiliesOtherEnding Systemic RacismTANF/ASPIRETax ReformUtilities

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