OnRamp Nomination Form

OnRamp Nomination Form

Dear Advocate: Use this form to nominate a worthy individual or couple to OnRamp for a vehicle donation. Your input in the application process is vital! We rely on trusted advocates to help us identify great clients. Please answer these questions to the best of your ability. Your answers will be kept confidential.

Nominee Details

Please provide the following details about the nominee.

Nominee First Name*

Nominee Last Name*

Nominee Email*

Advocate Details

Please provide the following details about you.

Advocates First Name*

Advocates Last Name*

Advocates Email*

OnRamp Advocate Requirements*

To serve as an advocate and nominate an individual or couple to OnRamp, you must agree with all of the following four requirements…

1. I work or volunteer with a local charity, church, ministry, school, health care provider, or government agency that is providing care, assistance, coaching, or training in some form to the individuals or family I want to nominate to OnRamp.

2. I have personally known the nominee (the person I am nominating) for at least six months (OnRamp can occasionally make exceptions on a case-by-case basis for as little as three months, but you must request an exception first)

3. I am willing to personally vouch for the nominee's character, that he or she is trustworthy and hard-working.

4. I am willing to walk with the nominee through the OnRamp process, including holding him or her accountable to mutually agreed upon action steps, attending an interview, and continuing to invest in this person’s life for a full year after the vehicle donation if the nominee is accepted into the OnRamp program. Barring unforeseen circumstances, if the applicant is gifted a vehicle by OnRamp, I commit to contact the applicant at least once a month for the next twelve months to ensure they stay focused on their goals and work hard to accomplish them, and I will update the OnRamp team about any major changes in the applicant's life.

I agree. I meet these requirements and am willing to accept these responsibilities.

I do not meet one or more of these requirements or am not able to accept these responsibilities at this time.

OnRamp Nominee Requirements*

Before proceeding, please verify that the person you are nominating meets ALL of the following requirements to be considered for the OnRamp program. OnRamp cannot currently accept clients that do not meet all these criteria. If you have questions about these requirements or would like us to consider a special exception, please send us an email (clientcare@onramptx.org) before continuing with this form.

1. Applicant lives in one of the seven counties of the Brazos Valley (Brazos, Burleson, Robertson, Grimes, Leon, Madison, or Washington) or following counties in the Coastal Bend: Victoria, DeWitt, Lavaca, Goliad, Calhoun, Jackson, Refugio, Aransas, Matagorda.

2. Applicant has a valid driver's license.

3. Applicant has positive monthly cash flow to afford insurance and fuel. To be specific, the applicant is either (1) already paying for fuel and insurance on an existing vehicle that needs to be replaced, or (2) making at least $200 a month MORE than all expenses so that he or she will have funds for insurance and fuel. If the answer is no, exceptions can be made but please email clientcare@onramptx.org with more information before continuing to fill out the rest of the application to assess whether an exception can be made.

4. Applicant has a full time job (30+ hours per week). If the answer is no, exceptions can be made but please email clientcare@onramptx.org with more information before continuing to fill out the rest of the application to assess whether an exception can be made.

5. Applicant is at least two years sober from any drug or alcohol addiction (in very limited situations, exceptions to this rule may be granted, but please contact OnRamp before proceeding).

6. Applicant is at least two years past any imprisonment, parole, or probation (in very limited situations, exceptions to this rule may be granted, but please contact OnRamp before proceeding).

Yes, my nominee meets all of these requirements OR I have already been granted an exception by OnRamp staff to proceed with the nomination.

No, my nominee does not meet all of these requirements at this time and I have not received an exception from OnRamp staff.

Have you been an OnRamp advocate in the past? In other words, have you already nominated someone to OnRamp AND they were accepted and gifted a vehicle?*

Yes

Name of your organization, institution, charity, church, or service provider, and what Texas county you are located in.*

What is the mission of your organization?*

What is your specific role in the organization?*

Your phone number, mobile preferred*

Phone

Your phone extension, if applicable

About the Nominee

Please provide the following details on your relationship with the nominee.

How long have you known the nominee for?*

(we typically desire six months, but can accept as little as three if the relationship is strong).

Please describe your relationship with this nominee including how much time you usually talk or meet per month. In what ways are you currently encouraging this nominee to move towards self-sufficiency?*

Are you capable and comfortable having conversations with the nominee about their personal growth and struggles? If no, please explain.*

Are you capable and comfortable having conversations with the nominee about their personal finances? If no, please explain.*

Please tell us a little about this person. Include basic family information, job and housing status, and this person's greatest strengths*

What personal struggles and/or circumstances have led to this person's need for transportation assistance? If they own or have access to a vehicle, why is it not meeting their needs?*

What steps has this person taken in the past or in the present to move towards self-sufficiency?*

How self-motivated is this applicant on a scale of 1-to-5? Note: your answer will not be shared with the applicant. Please be as forthcoming as possible so we’ll know how best to evaluate and potentially serve this applicant.

Select

How will a reliable vehicle help this person accomplish goals, better his or her life, and serve his or her family and community?*

Please give us any additional reasons why this person or family deserves to be considered for an OnRamp vehicle donation. Please be specific.

How did you or your nominee hear about OnRamp?

Send me a copy of my responses

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