Apply For Aid from DMA Trans Assistance Fund
Use this form to apply for assistance from a special fund for helping DeKalb, IL-area Trans people. If you need more information, you can contact DeKalb Mutual Aid via our Facebook or by emailing DMA directly.
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Name we can call you and your pronouns? (e.g., "Sata Prescott, he/they" *
Best way to directly contact you? (e.g., "Email: themostprescott@gmail.com")

What do you need help with right now? From medical care to food to interview preparation to haircuts or genuinely anything that can help you achieve your needs. (e.g., "I need a name change.")

What should we know about your situation that isn’t otherwise described in this application? (e.g. "I'm in the closet and live with my parents, so I need to be quiet about what I'm doing.")
Would you like to get involved and help out with Dekalb Mutual Aid? The answer to this question will have no impact on the help you can receive.
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