Request edit access
Application for Helping Out Assistance
This form is to apply for funding assistance or non-financial support that Trans qathet can offer. Your application will be reviewed within 14 days of submission, you can expect to be contacted within 7 days of your application reviewal.

We will do our best to contact you as soon as we can, and we encourage you to reach out to us if your need for support is time-sensitive - you can call Laurance at 604-414-6187, or email us at info@transqathet.ca for a quicker response.

Please note: We will hold people accountable who misrepresent themselves in any way, including their gender identity, to access funding and/or support resources from Trans qathet. Doing so constitutes fraud and you will be expected to pay back the organization the value of all monies and/or services received and/or face criminal charges, depending on the severity of that theft.
Sign in to Google to save your progress. Learn more
Email *
Phone number (optional)
Preferred method of contact: *
Your Name: *
Your pronouns: *
Your current legal name: *
We only ask in the event of emergency or legal use, please also include future legal name if you are planning to or in the process of legally changing your name.
Are you a minor? *
A minor is someone who is under 19 years of age in BC. We only ask for legal purposes.
Do you identify as trans or gender diverse? *
Someone who is trans or gender diverse is anyone whose gender identity is different than that presumed at birth, regardless of age, name, pronouns, and status or desire to medically or socially transition.
What type of assistance are you in need of? *
Required
What is the estimated cost of supports that you are in need of? *
How would you describe your financial security? *
I have no money, no means of income, and am in debt
I can easily afford all of my living expenses as well as superfluous luxuries, like my multiple yachts and vacation properties
How would you describe your financial security?
If you don't feel comfortable including this information feel free to skip this question. Please answer this question if you checked  "Yes" for being in need of financial assistance in the previous question.
Are you at risk of homelessness? *
Are you at risk of abuse within your own home? *
This could be financial, physical, emotional, or psychological abuse.
By what date do you require assistance, if time sensitive?
If you require urgent assistance, please contact us directly at (604) 414-6187 or info@transqathet.ca, as well as submitting your application form.
MM
/
DD
/
YYYY
How did you hear of Trans qathet and this project?
Is there anything else you need us to know when we contact you?
If you need us to use different name and/or pronouns when referring to you via certain contact methods we can accommodate this!
Are you applying on behalf of yourself or someone else? *
If you are applying on behalf of someone else, please fill out the following fields. If you are applying for yourself please proceed to the bottom of the form and hit "Submit"
Your name:
Only applicable if applying on behalf of someone else
Your pronouns:
Only applicable if applying on behalf of someone else
Phone number (optional)
Only applicable if applying on behalf of someone else
Your email:
Only applicable if applying on behalf of someone else
Preferred method of contact:
Only applicable if applying on behalf of someone else
Clear selection
What is your relationship to the applicant?
Only applicable if applying on behalf of someone else
Anything else we need to know?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms