Request edit access
Trans Futures Health Fund
Micro grant requests for trans, nonbinary, and gender nonconforming people in central and western Virginia!
* Required
First Name (the name that you want us to use - we don't need to know your legal name)
*
Your answer
Last Name
*
Your answer
Pronouns (i.e. she/they/he/ze)
*
Your answer
Race/Ethnicity
Your answer
Phone Number
*
Your answer
Email Address
Your answer
Best way to contact you
Text
Email
Other:
Clear selection
City/Town of Residence
*
Your answer
How can we help you?
*
Your answer
Is there a specific amount of money you are in need of? (We are typically able to send $50-$200 per person)
Your answer
Please list your Venmo (preferred) or PayPal information for us to send money to.
Your answer
Is there anything else you want us to know?
Your answer
Our goal is to distrubute funds to transgender, non binary, and other gender-expansive people in central and western Virginia. Does this apply to you?
*
Yes
No (if no, please explain your reason for contacting us below)
Other:
How did you hear about us?
Your answer
We are a collective of four people working to redistribute money within our community. We will get to your request as quickly as we can. We receive a large volume of inquiries and we want to make sure everyone gets their needs met. We hope to respond to you within 3-5 days and we appreciate your patience.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
